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Dr. Jackson Petty , DDS

Dentist - General Practice β€’ Tullahoma, TN

Active NPI 1417565193 Individual Practitioner
Practice location in NPPES

2118 N Jackson St
Tullahoma, TN 373882208

Call 9314549499 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2118 N Jackson St

Tullahoma, TN 373882208

Telephone 9314549499
Fax 9314549499
Organization at the Same NPPES Address or Phone
Petty Dental, Pllc Facility NPI 1215747100

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

30-day fills

11 standardized 30-day fills in 2023

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$34 in 2023

The total cost of these prescriptions in 2023, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2023.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Tullahoma and Tennessee

Billing and prescribing volume is not a quality rating.

Medicare Part D

Comparisons use 2024 data. The latest CMS data for Dr. Petty are from 2023.

14 active clinicians are listed under Dentist - General Practice with a practice address in Tullahoma, TN (2,027 in Tennessee).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Tullahoma

0% of these 14 clinicians have the CMS telehealth indicator.

0% of these 14 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Medicare Part D Prescribers (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2023.

CMS Part D Β· Data Year 2023
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Amoxicillin Amoxicillin 11 73 $34.12 11

Source: CMS Part D by Provider and Drug, 2023; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-01-21
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES TN 11423

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.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES CO 204657

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Tennessee Department of Health License Verification.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Dr. John Petty , DMD

Dentist - General Practice

NPI 1558352997

Doctor of Dental Medicine

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 12, 2025

Dentist (license number reported to NPPES: CO 204657)

πŸ“
Updated Practice Location October 03, 2024

Registered at 2118 N JACKSON ST, TULLAHOMA, TN 373882208 (Tel: 9314549499)

πŸ“
Updated Business Mailing Address October 03, 2024

Registered at 2118 N JACKSON ST, TULLAHOMA, TN 373882208 (Tel: 3145494999)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2024

Dentist (license number reported to NPPES: TN 11423)

πŸ“
Updated Practice Location July 19, 2021

Registered at 128 MARKET ST, ALAMOSA, CO 811012290 (Tel: 7195871001)

πŸ“
Updated Business Mailing Address July 19, 2021

Registered at 128 MARKET ST, ALAMOSA, CO 811012290 (Tel: 7195871001)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2021

Dentist (license number reported to NPPES: CO 204657)

βœ…
NPI Profile Active July 17, 2020

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 17, 2020

Registered at 8210 FLOYD CURL DR # 8103, SAN ANTONIO, TX 782293923 (Tel: 2104503273)

πŸ“
Business Mailing Address (Initial Record) July 17, 2020

Registered at 8210 FLOYD CURL DR # 8103, SAN ANTONIO, TX 782293923 (Tel: 2104503273)

πŸ‘€
Provider Name / Credentials (Initial Record) July 17, 2020

Recorded as JACKSON PETTY, DDS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2020

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration July 17, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1417565193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 17, 2020
Last Update: January 21, 2025
Sole Proprietor: No

Other Dentist - General Practices in Tullahoma

All Dentist - General Practices in Tullahoma

Mailing Address

2118 N Jackson St

Tullahoma, TN 373882208

Phone: 9314549499

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.