Individual provider · Type 1 NPI

Reynaldo Jackson, DMD

General Practice Dentistry · Chicago, IL

NPI number 1407435696 Active

Practice location

9521 S Western Ave
Chicago, IL 60643-1013

Call (773) 344-9120 Map

Mailing address

10510 Gravelly Lake Dr SW
Lakewood, WA 98499-5036

Other practice locations

  • 10510 Gravelly Lake Dr SW, Lakewood, WA 98499-5036 · (253) 589-7030

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000XDE61346798 (WA)
General Practice Dentistry Primary 1223G0001X019.036510 (IL)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4 other providers at this address

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About NPI 1407435696

Reynaldo Jackson, DMD's National Provider Identifier is 1407435696, issued on Apr 5, 2021. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Chicago, IL. The record was last updated on Sep 12, 2025.