1. Home
  2. Directory
  3. NPI Profile

MERSEDES S. JACKSON DDS
NPI 1639664527
Dentist in Fort Gregg-adams, VA

Active since June 25, 2018PECOS Enrolled
KENNER ARMY HEALTH CLINIC, 700 24TH STREET, FORT GREGG-ADAMS, VA 23801(804) 734-5365 Get Directions Write a Review

NPPES record last updated: November 7, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 7, 2024, Jul 16, 2018, Jun 25, 2018 (3 updates tracked since 2018).

About Mersedes S. Jackson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MERSEDES S. JACKSON DDS (NPI 1639664527) is an individual dentist in Fort Gregg-adams, Virginia, licensed in Virginia (0401416895) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639664527
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameMERSEDES S. JACKSONCredential: DDS
Location AddressKENNER ARMY HEALTH CLINIC, 700 24TH STREETFort Gregg-adams, VA 23801
Mailing AddressKenner Army Health Center, 700 24th StreetFort Gregg-adams, VA 23801 · (804) 734-5365
Phone(804) 734-5365
Sole ProprietorYes
Enumeration DateJune 25, 2018
Last NPPES UpdateNovember 7, 20243 updates tracked since enumeration
NPPES CertifiedNovember 4, 2024
✔ NPI 1639664527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in VA · 0401416895
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
KENNER ARMY HEALTH CLINIC, Fort Gregg-adams, VA 23801
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mersedes S. Jackson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23801 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$70.08 typical visit price
range $18.07 – $138.91
Typical copayment $17.52 (range $4.51 – $34.72)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARAT V. ZANOV
Psychologist (Clinical)
KENNER ARMY HEALTH CLINIC, 700 24TH STREET
FORT GREGG-ADAMS, VA 23801
Prince George County (804) 734-9143
MR. HUGH ANSTETT LCSW
Social Worker (Clinical)
KENNER ARMY HEALTH CLINIC, 700 24TH STREET
FORT LEE, VA 23801
Prince George County (804) 734-9143
MRS. MARY E. BERGMAN PA-C
Physician Assistant
KENNER ARMY HEALTH CLINIC, 700 24TH ST
FORT LEE, VA 23801
Prince George County (804) 734-9491
DR. DEAN MILLER MD
General Practice
KENNER ARMY HEALTH CLINIC, 700 24TH STREET
FORT GREGG-ADAMS, VA 23801
Prince George County (804) 734-8000
DR. ROBERT KEITH LATHER MD
Emergency Medicine
KENNER ARMY HEALTH CLINIC, PRIMARY CARE DIVISION
FT LEE, VA 23801
Prince George County (804) 734-9251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mersedes Jackson's NPI number?

The NPI number for Mersedes Jackson is 1639664527. It was assigned to this individual provider in the NPPES registry on June 25, 2018.

Where is Mersedes Jackson located?

Mersedes Jackson practices at Kenner Army Health Clinic 700 24th Street, Fort Gregg-Adams, VA 23801. The listed phone number is (804) 734-5365.

What is Mersedes Jackson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Mersedes Jackson enrolled in Medicare?

Yes. Mersedes Jackson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mersedes Jackson was last updated on November 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.