Organization
JACKSON DENTAL CORPORATION
Active
Other names
REDLANDS DENTAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANISHA A JACKSON DDS (OWNER DDS)
(909) 792-7500
Entity
Organization
Contact information
Practice address
422 ORANGE ST, REDLANDS, CA 92374-3206
(909) 792-7500
(909) 792-7503
Mailing address
2860 MICHELLE, 2ND FLOOR, IRVINE, CA 92606-1009
(714) 508-3600
(714) 368-2092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
47103
CA
1223P0300X
Periodontics
43860
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
51692
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
50851
CA
Other
Enumeration date
10/03/2006
Last updated
09/11/2025
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