Organization
BEAVERCREEK OH - KYLE JACKSON DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGI EVANS (CREDENTIALING MANAGER)
(720) 603-4800
Entity
Organization
Contact information
Practice address
4090 INDIAN RIPPLE RD STE 102, DAYTON, OH 45440-3292
(937) 986-1886
Mailing address
4090 INDIAN RIPPLE RD STE 102, DAYTON, OH 45440-3292
(937) 986-1886
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
02/16/2026
Last updated
02/16/2026
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