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

Active since December 01, 2014PECOS Enrolled
3901 CENTRAL PIKE STE 500, HERMITAGE, TN 37076(159) 337-3006 Get Directions Write a Review

NPPES record last updated: November 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 15, 2025, Jan 28, 2017 (2 updates tracked since 2017).

About Latresa Jackson Dmd NPPES

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

LATRESA JACKSON DMD (NPI 1720485121) is an individual general practice provider in Hermitage, Tennessee, licensed in Tennessee (9957) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720485121
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameLATRESA JACKSONCredential: DMD
Location Address3901 CENTRAL PIKE STE 500Hermitage, TN 37076-3431
Mailing Address3901 Central Pike Ste 500Hermitage, TN 37076-3431 · (615) 933-7300
Phone(159) 337-3006
Sole ProprietorNo
Enumeration DateDecember 1, 2014
Last NPPES UpdateNovember 1, 20252 updates tracked since enumeration
NPPES CertifiedNovember 1, 2025
✔ NPI 1720485121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in TN · 9957✔ Licensed in KY · 10893
Definition
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.
3901 CENTRAL PIKE STE 500, Hermitage, TN 37076
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma 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)

Latresa Jackson Dmd 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 37076 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
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 15

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

MEERA M GANDHI PA-C
Physician Assistant (Medical)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (027) 920-2365
BROOKE ELIZABETH KING OTR/L
Occupational Therapist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (502) 792-0236
MADISON ROSE LAMBRECHT CCC-SLP
Speech-Language Pathologist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (502) 792-0236
ALLEN WONG DDS
Dentist (General Practice)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (615) 933-7300
ALEXANDRA F KOPACK BCBA
Behavior Analyst
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (502) 792-0236
SAMEER SOOD D.O
Family Medicine
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (502) 792-0236
ONIKA LANGFORD MSN, APRN, FNP-C
Nurse Practitioner (Family)
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (502) 792-0236
KRAMER DAVIS TENNESSEE LLC
Specialist
3901 CENTRAL PIKE STE 500
HERMITAGE, TN 37076
Davidson County (615) 933-7300

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 Latresa Jackson's NPI number?

The NPI number for Latresa Jackson is 1720485121. It was assigned to this individual provider in the NPPES registry on December 1, 2014.

Where is Latresa Jackson located?

Latresa Jackson practices at 3901 Central Pike Ste 500, Hermitage, TN 37076. The listed phone number is (159) 337-3006.

What is Latresa Jackson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Latresa Jackson enrolled in Medicare?

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

What insurance does Latresa Jackson accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Guardian and 4 other insurers list Latresa Jackson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Latresa Jackson was last updated on November 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.