Individual provider

Latresa Jackson, DMD

General Practice Dentistry Medicare enrolled

Latresa Jackson, DMD is a provider specialising in General Practice Dentistry in Hermitage, TN, registered under NPI 1720485121.

Getting there

The practice address on file is 3901 CENTRAL PIKE STE 500, Hermitage, TN 37076. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

3901 CENTRAL PIKE STE 500, Hermitage, TN 37076 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
9957 TN General Practice Dentistry primary
10893 KY General Practice Dentistry

Licences are recorded in 2 states: TN, KY. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Dentist
PAC ID
3779002126
Enrollment ID
I20250528003797

Medicare enrolment is recorded as approved under the provider type Practitioner - Dentist. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Kentucky and Tennessee. The practice address on file is in Hermitage, TN, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

KY Kentucky
Licence
10893
Specialty
General Practice Dentistry
Verify with the KY board →
TN Tennessee practice address
Licence
9957
Specialty
General Practice Dentistry
Verify with the TN board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What General Practice covers

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. NUCC Health Care Provider Taxonomy, code 1223G0001X
Dental Providers Dentist General Practice

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
1223G0001X General Practice Dentistry General Practice 9957 TN primary
1223G0001X General Practice Dentistry General Practice 10893 KY

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1720485121 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateDec 1, 2014
Last updatedNov 1, 2025
StatusActive
Sole proprietorNo
CredentialDMD
Practice address 3901 CENTRAL PIKE STE 500
Hermitage, TN 37076
(159) 337-3006
This record was updated on Nov 1, 2025, which is recent enough that the contact details are likely still accurate.

Number check

1720485121 passes the NPI check digit test The final digit 1 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 7 2 0 4 8 5 1 2
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 7 4 0 8 8 1 1 4

Sum = 59 · next multiple of 10 = 60 · check digit = 1 · actual last digit = 1

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1720485121?
NPI 1720485121 is the National Provider Identifier assigned to Latresa Jackson, DMD in Hermitage, TN. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does General Practice cover?
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.
How do I contact Latresa Jackson, DMD?
The phone number on file with NPPES is (159) 337-3006, last updated Nov 1, 2025. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Latresa Jackson, DMD accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1720485121 a valid number?
Yes. 1720485121 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.