Larry Jackson, D.D.S.
NPI 1396186276 · Pediatric Dentistry · Peoria, AZ
Enrolled with Medicare as Order and Referring Only - Other (physician) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Larry Jackson, D.D.S. is a Pediatric Dentistry provider in Peoria, AZ (NPI 1396186276).
Provider details
- NPI number
- 1396186276
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- D009113 (AZ)
Specialties & taxonomies
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-07-08
- Last updated
- 2017-04-07
Frequently asked questions
- What is Larry Jackson's NPI number?
- Larry Jackson's National Provider Identifier (NPI) is 1396186276, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Larry Jackson's specialty?
- Larry Jackson is listed in the NPPES registry with a primary specialty of Pediatric Dentistry (Dental Providers).
- Where is Larry Jackson located?
- Larry Jackson's practice location on file with NPPES is 14100 N 83rd Ave, Peoria, AZ 85381-5658.
- What is Larry Jackson's phone number?
- The practice phone number listed in the NPPES registry for Larry Jackson is (623) 935-9873.
- Does Larry Jackson accept Medicare?
- Larry Jackson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Larry Jackson's NPI active?
- Yes — Larry Jackson's NPI (1396186276) is active in the NPPES registry as of the last update on 2017-04-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.