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Individual
DR. MATTHEW DV JACKSON
Active
Individual
DR. MATTHEW DV JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
KS7131
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059792
BCBS OF KS
KS
01
—
976141
UNITED CONCORDIA
—
Enumeration date
01/10/2006
Last updated
07/13/2026
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