Ryne Jackson, DMD, MSD
NPI 1619538436ActiveIndividual· Dentist, Endodontics· Surprise, AZ
Dentist, Endodontics (DMD, MSD) in Surprise, Arizona, licensed in AZ and LA, with an NPI issued in June 2019. Part D covered 107 prescriptions written in 2024, 100% of them generic.
Overview
| NPI | 1619538436 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DMD, MSD |
| Sole proprietor | Yes |
| NPI issued | Jun 24, 2019 |
| Last updated in NPPES | Jul 14, 2025 |
| Certified by provider | Jul 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Endodontics Primary | 1223E0200X | D012024 | AZ |
| Dentist | 122300000X | 7005 | LA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 107 · 107 30-day fills |
|---|---|
| Patients | 77 |
| Total drug cost | $358.81 |
| Generic share | 100% of claims |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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