LATRESA JACKSON DMD
NPI 1720485121
Dentist - General Practice in Hermitage, TN

NPI Status: Active since December 01, 2014

Contact Information

3901 CENTRAL PIKE STE 500
HERMITAGE, TN
ZIP 37076
Phone: (159) 337-3006

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  • Individual
  • Female
  • Years of Experience 13
  • Dentist
  • General Practice
  • Accepts Insurance
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About LATRESA JACKSON

This page provides the complete NPI Profile along with additional information for Latresa Jackson, a provider established in Hermitage, Tennessee with a medical specialization in Dentist, focusing in general practice and more than 13 years of experience. She graduated from University Of Louisville School Of Dentistry in 2013. The healthcare provider is registered in the NPI registry with number 1720485121 assigned on December 2014. The practitioner's primary taxonomy code is 1223G0001X with license number 9957 (TN). The provider is registered as an individual and her NPI record was last updated one year ago.

NPI
1720485121
Provider Name
LATRESA JACKSON DMD
Gender
Female
Entity Type
Individual
Location Address
3901 CENTRAL PIKE STE 500 HERMITAGE, TN 37076
Location Phone
(159) 337-3006
Mailing Address
3901 CENTRAL PIKE STE 500 HERMITAGE, TN 37076
Mailing Phone
(615) 933-7300
Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
12-01-2014
Last Update Date
11-01-2025
Code Navigator

A dentist like Latresa Jackson is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
License No.
9957
License State
TN
Taxonomy Description
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223G0001XDental Providers

Dentist
General Practice

10893 (KY)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BEST Life Preferred Dental Plan - PPO
  • BEST Life Superior Dental Plan - PPO
  • BEST Life Essental Preferred Dental Plan - PPO
  • BEST Life Essental Value Dental Plan - PPO
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Basic Dental - PPO
  • BEST Life Essential Basic Dental Plan - Indemnity
  • BEST Life Essential Basic Dental Plan - PPO
  • BEST Life Essential Value Dental Plan - PPO
  • BEST Life Essential Value Dental - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • BlueCare Dental? 1D - PPO
  • BlueCare Dental 1D - PPO
  • BlueCare Dental 4 Kids? 1A - PPO
  • BlueCare Dental 4 Kids? 1B - PPO
  • BlueCare Dental? 1A - PPO
  • BlueCare Dental? 1B - PPO
  • BlueCare Dental? 1C - PPO
  • Guardian Basics for Families and Individuals - PPO
  • Guardian Essentials for Families and Individuals - PPO
  • Guardian Preventive Plus for Families and Individuals - PPO
  • Guardian Select for Families and Individuals - PPO
  • HRI Essential Plus Plan - HMO
  • HRI Essential Plus Plan - PPO
  • HRI Preventive Family Plan - HMO
  • HRI Preventive Family Plan - PPO
  • HRI Total Care Plan - HMO
  • HRI Total Care Plan - PPO
  • Humana Dental Smart Choice - PPO
  • Humana Dental Smart Choice - Basic - PPO
  • Humana Dental Smart Choice - High - PPO
  • Humana Dental Smart Choice - Lite - PPO
  • Humana Dental Smart Choice - Low - PPO
  • Paramount Dental Essential Plus Plan - EPO
  • Paramount Dental Preventive Family Plan - EPO
  • Paramount Dental Total Care Plan - EPO
  • Lone Star - Smile Now - PPO
  • Smile Now Arizona - No Waiting Period PPO - PPO
  • Smile Now Michigan - No Waiting Period PPO - PPO
  • Smile Now Ohio - No Waiting Period PPO - PPO
  • Smile Now Texas- No Waiting Period Plan - PPO
  • Smile Now Utah - No Waiting Period PPO - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Latresa Jackson is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Latresa Jackson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3779002126

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250528003797

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: No

Physician Visit Costs

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37076 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.53
  • Minimum New Patient Price $52.64
  • Maximum New Patient Price $160.89
  • Average New Patient Copayment $20.38
  • Minimum New Patient Copayment $13.16
  • Maximum New Patient Copayment $40.22

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.01
  • Minimum Established Patient Price $16.72
  • Maximum Established Patient Price $131.41
  • Average Established Patient Copayment $16.5
  • Minimum Established Patient Copayment $4.18
  • Maximum Established Patient Copayment $32.85

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for LATRESA JACKSON DMD

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1720485121, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
4
Doubled → 8
Pos 6
8
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
1
Unchanged
Pos 9
2
Doubled → 4
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 4 → 8 5 → 10 → 1 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 4 + 0 + 8 + 8 + 1 + 0 + 1 + 4 + 24 = 59

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 59 is 60. The difference is the calculated check digit.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1720485121.

Other Providers at the Same Location


The following 16 providers are registered at the same or a nearby location.

Occupational Therapist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Physical Therapist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Physician Assistant (Medical)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Speech-Language Pathologist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Behavior Analyst
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Family Medicine
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Dentist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Dentist (General Practice)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Physician Assistant
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Nurse Practitioner (Family)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Nurse Practitioner (Family)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Nurse Practitioner (Psychiatric/Mental Health)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Specialist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Dentist (General Practice)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Specialist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Nurse Practitioner (Family)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720485121, enumerated as an "individual" on December 01, 2014.

The provider is located at 3901 CENTRAL PIKE STE 500 HERMITAGE, TN 37076 and the phone number is (159) 337-3006.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.

The provider might be accepting Accepts: BEST Life, Blue Cross and Blue Shield of Montana,. Please consult your insurance carrier or call the provider to verify.