Theodore Jackson, D.M.D

NPI 1912981945 · on the registry since 2005

Practice

Address: 305 W 12th Ave
Columbus, OH 43210
Phone: (614) 247-6590
Organisation at this address: College Of Dentistry
The Ohio State University
The Ohio State University
Dental Clinics College Of Dentistry
Ohio State Dental Faculty Practice Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 275

Registry record

Primary taxonomy: 122300000X
122300000X
Also registered as: 1223G0001X
Licence states on file: IL, OH
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2023-02-21

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 Ohio