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NPI Code Detail

MEDICARE: DR. ARIANNA JACKSON DDS

MEDICARE: DR. ARIANNA JACKSON DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist61640KS

General Provider Information

NPI Number : 1932760303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ARIANNA JACKSON DDS
Provider Business Mailing Address
First Line : 3801 DR MARTIN LUTHER KING JR BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64130-2807
Country : US
Telephone Number : 816-923-5800
Fax Number : 816-922-1070
Provider Business Practice Location Address
First Line : 21 N 12TH ST STE 400
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102-5172
Country : US
Telephone Number : 816-599-5111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2019
Last Update Date : 12/26/2025

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Directions to “ DR. ARIANNA JACKSON DDS” Practice Location

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