IndividualActive
Charles Jackson, Jr., DDS, MSD
NPI 1972563690 · Orthodontics and Dentofacial Orthopedics Dentistry · Sandy, UT
Provider details
- NPI number
- 1972563690
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DDS, MSD
- Sex
- Male
- License
- 142729-9921 (UT)
Specialties & taxonomies
Dental Providers
Practice location
669 Union Sq
Sandy, UT 84070-3404
Phone: (801) 571-1231
Fax: (801) 571-9738
Approximate (ZIP-level) locationGet directions
Mailing address
669 Union Sq
Sandy, UT 84070-3404
Registry dates
- Enumerated
- 2006-03-25
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.