Jackson Boulevard Dental Associates
NPI 1629315932ActiveOrganization· Dentist· Rapid City, SD
Dentist in Rapid City, South Dakota, registered in NPPES in January 2013. The authorized official on file is Jared L. Taylor, DMD, Owner.
Overview
| NPI | 1629315932 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 7, 2013 |
| Last updated in NPPES | Oct 13, 2021 |
| Certified by provider | Oct 13, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist Primary | 122300000X | M636 | SD |
| Dentist | 122300000X | D1002 | SD |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 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 |
|---|
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