Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Jackson Family Dental Gladstone LLC

Organization General Practice Dentistry · NPI 1194115865

Jackson Family Dental Gladstone LLC provides General Practice Dentistry in Gladstone, Missouri. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2109 NE 72nd St Ste 104
Gladstone, MO 64118-2304 Not confirmed with CMS for 11 years — call before visiting
Phone: (816) 453-3100
Fax: (816) 453-3180
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1194115865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jesse Jackson — Member · (816) 429-5799
NPI enumeratedFebruary 2, 2015
Last updated in NPPESFebruary 2, 2015
Mailing address2109 Ne 72nd St, Ste 104, Gladstone, MO 64118-2304

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