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Reynaldo Jackson, DMD
NPI 1407435696 · General Practice Dentistry · Chicago, IL
Reynaldo Jackson, DMD is a General Practice Dentistry provider in Chicago, IL (NPI 1407435696).
Provider details
- NPI number
- 1407435696
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- DE61346798 (WA)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
Established profile(67/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
9521 S Western Ave
Chicago, IL 60643-1013
Phone: (773) 344-9120
Street-level locationGet directions
Mailing address
10510 Gravelly Lake Dr Sw
Lakewood, WA 98499-5036
Additional practice locations (1)
- 10510 Gravelly Lake Dr SwLakewood, WA 98499-5036Phone: (253) 589-7030
Registry dates
- Enumerated
- 2021-04-05
- Last updated
- 2025-09-12
- Certified
- 2025-09-12
Frequently asked questions
- What is Reynaldo Jackson's NPI number?
- Reynaldo Jackson's National Provider Identifier (NPI) is 1407435696, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Reynaldo Jackson's specialty?
- Reynaldo Jackson is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Reynaldo Jackson located?
- Reynaldo Jackson's practice location on file with NPPES is 9521 S Western Ave, Chicago, IL 60643-1013.
- What is Reynaldo Jackson's phone number?
- The practice phone number listed in the NPPES registry for Reynaldo Jackson is (773) 344-9120.
- Is Reynaldo Jackson's NPI active?
- Yes — Reynaldo Jackson's NPI (1407435696) is active in the NPPES registry as of the last update on 2025-09-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.