OrganizationActive
Clubhouse Pediatric Dentistry of Jackson
NPI 1942775960 · Pediatric Dentistry · Jackson Hole, WY
Clubhouse Pediatric Dentistry of Jackson is a Pediatric Dentistry organization in Jackson Hole, WY (NPI 1942775960).
Provider details
- NPI number
- 1942775960
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Courtney Jackson, Pediatric Dentist(307) 733-5439
Specialties & taxonomies
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
7 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
1130 US-89
Jackson Hole, WY 83001-8701
Phone: (307) 733-5439
Street-level locationGet directions
Mailing address
3210 E 81st S
Idaho Falls, ID 83406-8302
Registry dates
- Enumerated
- 2018-10-05
- Last updated
- 2018-10-05
Frequently asked questions
- What is Clubhouse Pediatric Dentistry of Jackson's NPI number?
- Clubhouse Pediatric Dentistry of Jackson's National Provider Identifier (NPI) is 1942775960, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Clubhouse Pediatric Dentistry of Jackson?
- Clubhouse Pediatric Dentistry of Jackson is classified in the NPPES registry as Pediatric Dentistry (Dental Providers).
- Where is Clubhouse Pediatric Dentistry of Jackson located?
- Clubhouse Pediatric Dentistry of Jackson's practice location on file with NPPES is 1130 US-89, Jackson Hole, WY 83001-8701.
- What is Clubhouse Pediatric Dentistry of Jackson's phone number?
- The practice phone number listed in the NPPES registry for Clubhouse Pediatric Dentistry of Jackson is (307) 733-5439.
- Who is the authorized official for Clubhouse Pediatric Dentistry of Jackson?
- The authorized official listed on Clubhouse Pediatric Dentistry of Jackson's NPPES record is Courtney Jackson, Pediatric Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Clubhouse Pediatric Dentistry of Jackson's NPI active?
- Yes — Clubhouse Pediatric Dentistry of Jackson's NPI (1942775960) is active in the NPPES registry as of the last update on 2018-10-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.