Doctor profile · Federal record
Dr. Stacy Jackson, DDS
Pediatric Dentist · Dentist · Boulder, CO
- NPI 1043530991
- 16 yrs on file
- Licensed in 2 states
- Female
- Solo practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
3400 Penrose Pl Ste 107
Boulder, CO 803011809
(303) 443-8250 - Additional location
-
5150 W 80Th Ave
Westminster, CO 800304449
(303) 427-1951 - Mailing address
-
291 Maddox Lane
Erie, CO 80516
Credentials & registration
- NPI registered
- June 2010 — 16 yrs on file
- Profile last updated
- April 26, 2023
- Specialty taxonomy
- 1223P0221X — NUCC code
- State licenses (2)
- Colorado #DEN.00202791 · Missouri #2010016174
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1043530991. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$143
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| ZIMVIE INC. | 1 | $143.30 |
By nature of payment
Frequently asked questions
What is Dr. Stacy Jackson's medical specialty?
Dr. Stacy Jackson practices Pediatric Dentist in Boulder, CO.
Where does Dr. Stacy Jackson practice?
Dr. Stacy Jackson practices at 3400 Penrose Pl Ste 107, Boulder, CO 803011809. Office phone: 3034438250.
What is Dr. Stacy Jackson's NPI?
Dr. Stacy Jackson's National Provider Identifier (NPI) is 1043530991, issued by NPPES.