What is Jackson Petty's NPI number?

Jackson Petty's National Provider Identifier (NPI) is 1417565193, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Jackson Petty's specialty?

Jackson Petty is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).

Where is Jackson Petty located?

Jackson Petty's practice location on file with NPPES is 2118 N Jackson St, Tullahoma, TN 37388-2208.

What is Jackson Petty's phone number?

The practice phone number listed in the NPPES registry for Jackson Petty is (931) 454-9499.

Is Jackson Petty's NPI active?

Yes — Jackson Petty's NPI (1417565193) is active in the NPPES registry as of the last update on 2025-01-21.

IndividualActive

Jackson Petty, DDS

NPI 1417565193 · General Practice Dentistry · Tullahoma, TN

Jackson Petty, DDS is a General Practice Dentistry provider in Tullahoma, TN (NPI 1417565193).

Provider details

NPI number: 1417565193
Entity type: Individual
Primary specialty: General Practice DentistryDental Providers
Credential: DDS
Sole proprietor: No
License: 204657 (CO)

Practice location

2118 N Jackson St

Tullahoma, TN 37388-2208

Phone: (931) 454-9499

Fax: (931) 454-9499

Street-level locationGet directions

More TN providers

Mailing address

2118 N Jackson St

Tullahoma, TN 37388-2208

Specialties & taxonomies

General Practice DentistryPrimary1223G0001XLicense 11423 (TN)
Dental Providers
General Practice Dentistry1223G0001XLicense 204657 (CO)
Dental Providers

Profile Score

Established profile(64/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
6 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Enumerated: 2020-07-17
Last updated: 2025-01-21
Certified: 2025-01-21

Frequently asked questions

What is Jackson Petty's NPI number?: Jackson Petty's National Provider Identifier (NPI) is 1417565193, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
What is Jackson Petty's specialty?: Jackson Petty is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
Where is Jackson Petty located?: Jackson Petty's practice location on file with NPPES is 2118 N Jackson St, Tullahoma, TN 37388-2208.
What is Jackson Petty's phone number?: The practice phone number listed in the NPPES registry for Jackson Petty is (931) 454-9499.
Is Jackson Petty's NPI active?: Yes — Jackson Petty's NPI (1417565193) is active in the NPPES registry as of the last update on 2025-01-21.

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Provider details

Practice location

Mailing address

Specialties & taxonomies

Profile Score

Registry dates

Frequently asked questions

Specialties & taxonomies

Profile Score

Frequently asked questions