Dr Latresa Jackson, DMD is a
Dentist - General Practice based in Elkton, Kentucky. Dr Latresa Jackson is licensed to practice in Kentucky (license number 10893) and her current practice location is
810 S Main St, Elkton, Kentucky. She can be reached at her office (for appointments etc.) via phone at
(270) 330-0008.
NPI number for Dr Latresa Jackson is 1720485121 and her current mailing address is 810 S Main St, Elkton, Kentucky. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1720485121.
Healthcare Provider's Profile
Full Name | Dr Latresa Jackson |
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Gender | Female |
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Speciality | Dentist - General Practice |
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Location | 810 S Main St, Elkton, Kentucky |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1720485121
- Provider Enumeration Date: 12/01/2014
- Last Update Date: 02/20/2024
Medical Identifiers
Medical identifiers for Dr Latresa Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1720485121 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 9957 (Tennessee) | Secondary |
1223G0001X | Dentist - General Practice | 10893 (Kentucky) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Latresa Jackson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Latresa Jackson, DMD 810 S Main St, Elkton, KY 42220-8812 Ph: (270) 330-0008 | Dr Latresa Jackson, DMD 810 S Main St, Elkton, KY 42220-8812 Ph: (270) 330-0008 |
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