Jan Jackson

NPI 1871535047 · on the registry since 2006

Practice

Address: 1460 W Main St
Suite 6
Sun Prairie, WI 53590
Phone: (608) 837-4814
Organisation at this address: Westside Dental
Mdc Sun Prairie Llc
L & D Enterprises, Inc.
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 4

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Also registered as: 101YM0800X
Licence states on file: WI
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2026-07-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin