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DR. JACKSON TUCKER GREEN DDS
NPI 1902535495
Student in an Organized Health Care Education/Training Program in Memphis, TN

Active since June 09, 2022PECOS Enrolled
875 UNION AVE, MEMPHIS, TN 38163(901) 448-1731 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2025, Jun 9, 2022 (2 updates tracked since 2022).

About Dr. Jackson Tucker Green Dds NPPES

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

DR. JACKSON TUCKER GREEN DDS (NPI 1902535495) is an individual student in an organized health care education/training program in Memphis, Tennessee, licensed in Arizona (D011416) and active in the NPI registry since June 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902535495
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JACKSON TUCKER GREENCredential: DDS
Location Address875 UNION AVEMemphis, TN 38163-2211
Mailing Address7794 Kings College Ave Apt 382Germantown, TN 38138-2098
Phone(901) 448-1731
Sole ProprietorNo
Enumeration DateJune 9, 2022
Last NPPES UpdateMay 12, 20252 updates tracked since enumeration
NPPES CertifiedMay 12, 2025
✔ NPI 1902535495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in AZ · D011416
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License D011416 (AZ)
875 UNION AVE, Memphis, TN 38163
Open in Google Maps ↗

Accepted Insurance

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

Dr. Jackson Tucker Green 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.

Other Providers at the Same Location NPPES 20

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

DR. JOHN DOUGLAS SEEBERG D.M.D
Dentist
875 UNION AVE
MEMPHIS, TN 38163
Shelby County (901) 448-6267
DR. MARK RANDALL PATTERS DDS
Dentist (Periodontics)
875 UNION AVE, UNIV. OF TENNESSEE, COLLEGE OF DENTISTRY
MEMPHIS, TN 38163
Shelby County (901) 448-7686
DR. RUSSELL O GILPATRICK DDS
Dentist (General Practice)
875 UNION AVE
MEMPHIS, TN 38163
Shelby County (901) 448-6202
DR. MARK A LACKEY DMD
Dentist
875 UNION AVE
MEMPHIS, TN 38163
Shelby County (901) 448-1883
DR. KENNETH MARK ANDERSON DDS,MS
Dentist (Oral and Maxillofacial Pathology)
875 UNION AVE, ROOM C309
MEMPHIS, TN 38163
Shelby County (901) 448-5876
DR. EDDIE L BURTON D.D.S.
Dentist (General Practice)
875 UNION AVE, SUITE N228
MEMPHIS, TN 38163
Shelby County (901) 448-6611
DR. DANIEL F. TYLKA D.M.D.
Dentist (Orofacial Pain)
875 UNION AVE, UTHSC COLLEGE OF DENTISTRY - UDFP
MEMPHIS, TN 38163
Shelby County (901) 448-6930
DR. LAWRENCE W WEEDA JR. DDS
Dentist (Oral and Maxillofacial Surgery)
875 UNION AVE, ROOM N-328
MEMPHIS, TN 38163
Shelby County (901) 448-6236

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 Jackson Green's NPI number?

The NPI number for Jackson Green is 1902535495. It was assigned to this individual provider in the NPPES registry on June 9, 2022.

Where is Jackson Green located?

Jackson Green practices at 875 Union Ave, Memphis, TN 38163. The listed phone number is (901) 448-1731.

What is Jackson Green's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jackson Green enrolled in Medicare?

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

What insurance does Jackson Green accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Arizona, EMI Health and Guardian and 7 other insurers list Jackson Green 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 Jackson Green was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.