OrganizationActive
Centerville Oh - Kyle Jackson DDS Inc
NPI 1730032210 · Pediatric Dentistry · Centerville, OH
Provider details
- NPI number
- 1730032210
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Maggi Evans, Credentialing Manager(720) 603-4800
Specialties & taxonomies
Dental Providers
Practice location
273 Regency Ridge Dr
Centerville, OH 45459-4221
Phone: (937) 586-7729
Approximate (ZIP-level) locationGet directions
Mailing address
273 Regency Ridge Dr
Centerville, OH 45459-4221
Registry dates
- Enumerated
- 2026-02-16
- Last updated
- 2026-02-16
- Certified
- 2026-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.