P Praxis·MD
● Active Type 1 · Individual

DR. Courtney Matthew Jackson, D.D.S.

Dentist·Rexburg, ID· NPI 1972864825 · Enumerated 2012 · 13 years on NPI
Jackson is 1 of 5 dentist providers in Rexburg and 1 of 114 in Idaho.
NPI age
13 years
Enumerated 2012-06-06
Primary specialty
Dentist
Plus 1 subspecialty
Licensed in
ID, WY
2 states
Status
Active
No deactivations on record
Last NPPES update
2016-02-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 114 active dentist providers in Idaho.

NPI age
13 years
≈ at median (13 yr)
State licenses
2 states
Top 86% — 13% of peers are multi-state
Subspecialties
0
32% of peers hold subspecialties

NPI lifetime · 2012 → 2026

2012-06Enumerated in NPPES
2012 2026

Where they practice

Practice location
859 S Yellowstone Hwy Ste 1202
Rexburg, ID 834406201
📞 2085525439fax 2085525440
Mailing address
859 S Yellowstone Hwy Ste 1202
Rexburg, ID 834406201
📞 2085525439fax 2085525440

Specialties

  • Dentist Primary
    An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
    ID license #D-4655-PDWY license #1433 taxonomy 1223P0221X

Practice context

Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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