JERRY DEANE TANKERSLEY D.M.D.
NPI 1710111034
Dentist in Clarksdale, MS

Q: What is Jerry Tankersley's NPI number?

The NPI number for Jerry Tankersley is 1710111034. It was assigned to this individual provider in the NPPES registry on May 14, 2009.

Q: What is Jerry Tankersley's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jerry Tankersley was last updated on June 30, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.

Active since May 14, 2009PECOS Enrolled

800 OHIO AVE, CLARKSDALE, MS 38614(662) 624-4292(662) 627-3629 Get Directions Write a Review

NPPES record last updated: June 30, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jerry Deane Tankersley D.m.d. NPPES

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

JERRY DEANE TANKERSLEY D.M.D. (NPI 1710111034) is an individual dentist in Clarksdale, Mississippi, licensed in Mississippi (2300-86) and active in the NPI registry since May 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710111034

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameJERRY DEANE TANKERSLEYCredential: D.M.D.

Location Address800 OHIO AVEClarksdale, MS 38614-7200

Mailing Address510 Highway 322Clarksdale, MS 38614-4717 · (662) 624-2504

Phone(662) 624-4292

Fax(662) 627-3629

Sole ProprietorNo

Enumeration DateMay 14, 2009

Last NPPES UpdateJune 30, 2009

✔ NPI 1710111034 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MS · 2300-86

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.

800 OHIO AVE, Clarksdale, MS 38614

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerry Deane Tankersley D.m.d. 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 38614 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

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$64.96 typical visit price

range $16.15 – $129.61

Typical copayment $16.24 (range $4.03 – $32.40)

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 12

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

CAROLYN D WOMACK LCSW

Social Worker (Clinical)