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Contact Information

ERNEST W JACKSON, DDS
111 S MERAMEC AVE
CLAYTON, MO63105-1711
 Phone: 314-615-8153
 Fax: 314-615-8303
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for ERNEST W JACKSON · (Male)

NPI # 1124113246
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 10/04/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 014969
  • MO Medicaid 406024208
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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