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Individual
JORDAN JACKSON CARACCI
Active
Individual
JORDAN JACKSON CARACCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4497-25
MS
1223P0221X
Pediatric Dentistry
Primary
111404
MS
1223P0221X
Pediatric Dentistry
4497-25
MS
Other
Enumeration date
05/22/2023
Last updated
08/12/2025
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