David Isaac Tucker, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

21380 Issued in TX

Practice address

2410 Stanley Road
Dentac Suite 200J
Fort Sam Houston, TX 78234-6230

Phone

(210) 295-2743

Fax

(210) 295-2602

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 16, 2016 through Dec 16, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ryan M Leonhart DDS MD PLLC

  dba South Texas Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
  • NPI 1346037454
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1053373175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 STANLEY ROAD",
            "address_2": "DENTAC SUITE 200J",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346230",
            "telephone_number": "210-295-2743",
            "fax_number": "210-295-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 STANLEY ROAD",
            "address_2": "DENTAC SUITE 200J",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782346230",
            "telephone_number": "210-295-2743",
            "fax_number": "210-295-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DAVID",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0021380",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "21380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Trimarchi, MD
• Tara Troianello, OTR/L
• Ellion Trotman, MD
• Timothy Tu
• Candice Brooke Tucker, LCSW
• Jennifer Tucker
• Angela Turner, M.A., PSY.D.
• Kathryn Ann Turner, LCSW
• Stephen Lee Turner, OTR/L
• Matthew Jonathan Tutterow, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.