OrganizationActive
Centerille Pediatric Dentistry, Kyle R Jackson, DDS, Inc
NPI 1386073112 · Pediatric Dentistry · Centerville, OH
Provider details
- NPI number
- 1386073112
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Kyle Jackson, Dentist/Owner(937) 586-7729
- License
- 30018976 (OH)
Specialties & taxonomies
Dental Providers
Practice location
273 Regency Ridge Dr
Centerville, OH 45459-4221
Phone: (937) 586-7729
Fax: (937) 660-4450
Approximate (ZIP-level) locationGet directions
Mailing address
273 Regency Ridge Dr
Centerville, OH 45459-4221
Registry dates
- Enumerated
- 2013-11-02
- Last updated
- 2016-08-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.