Mersedes S Jackson, DDS is a medicare enrolled "Dentist" provider in Fort Gregg-adams, Virginia. Her current practice location is
Kenner Army Health Clinic, 700 24th Street, Fort Gregg-adams, Virginia. You can reach out to her office (for appointments etc.) via phone at
(804) 734-5365.
Mersedes S Jackson is licensed to practice in Virginia (license number 0401416895) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1639664527.
Healthcare Provider's Profile
Full Name | Mersedes S Jackson |
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Gender | Female |
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Speciality | Dentist |
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Location | Kenner Army Health Clinic, Fort Gregg-adams, Virginia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1639664527
- Provider Enumeration Date: 06/25/2018
- Last Update Date: 11/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698023430
- Enrollment ID: I20180809005881
Medical Identifiers
Medical identifiers for Mersedes S Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1639664527 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 0401416895 (Virginia) | 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. Mersedes S Jackson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mersedes S Jackson, DDS Kenner Army Health Center, 700 24th Street, Fort Gregg-adams, VA 23801 Ph: (804) 734-5365 | Mersedes S Jackson, DDS Kenner Army Health Clinic, 700 24th Street, Fort Gregg-adams, VA 23801 Ph: (804) 734-5365 |
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