DR. JACKSON A BEAN (D.D.S.) – Dentist, NPI 1861610545

DR. JACKSON A BEAN (D.D.S.) is a healthcare provider. based in Greenville, Texas. specializing in Dentist. They hold the professional credentials D.D.S.. They hold a License No. 21382 (TX). The NPI Number for DR. JACKSON A BEAN (D.D.S.) is 1861610545

Main info

Male
Sole Proprietor
Name
DR. JACKSON A BEAN (D.D.S.)
NPI
1861610545
Phone
(903) 454-6661
Address
2704 AILEEN BLVD
Enumeration Date
20 April 2007
Last Update Date
11 March 2013
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for DR. JACKSON A BEAN (D.D.S.)

  • 2704 AILEEN BLVD

    GREENVILLE, TX 754026486

    Phone: (903) 454-6661

    Fax: (903) 454-6661

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 23 Open Payments records for all available years, with a total value of $580.

Total Amount is formed as General ($580) + Research ($0) + Ownership ($0) = $580.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Align Technology, Inc. ($269).

Total Amount

$580

General + Research + Ownership

Payments

23

Total payment records

General Amount

$580

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-05-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210527000327IDentistTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75402)

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Reviews

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Frequently asked questions

Is DR. JACKSON A BEAN (D.D.S.) listed with a National Provider Identifier?
Yes — DR. JACKSON A BEAN (D.D.S.) has NPI 1861610545 on file in the registry.
Active or inactive — what applies to DR. JACKSON A BEAN (D.D.S.)?
You should see DR. JACKSON A BEAN (D.D.S.) as active in CMS-hosted NPPES data.
How would a patient describe DR. JACKSON A BEAN (D.D.S.)'s focus?
For DR. JACKSON A BEAN (D.D.S.), the primary taxonomy reads as Dentist. Clinical services aligned with this taxonomy classification.
Where in Texas is DR. JACKSON A BEAN (D.D.S.) registered?
Use Greenville, Texas as the headline location for DR. JACKSON A BEAN (D.D.S.) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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