NPIMap

Organization Active NPI

Scott F Tucker, DDS Ms PA

Doing business as University Dental Associates

  • General Practice Dentistry
  • Winston Salem, NC
National Provider Identifier
1063589711
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SCOTT F TUCKER, DDS MS PA
Doing business as
University Dental Associates
University Dental Associates Pediatrics
Practice address
2231 Cloverdale Ave
Winston Salem, NC 27103-2301
Phone
(704) 547-1970
Fax
(704) 547-1926
NPI assigned
Nov 29, 2006
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Hillary Thull
Title
Senior Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

2231 Cloverdale Ave
Winston Salem, NC 27103-2301

Mailing address

PO Box 505117
Saint Louis, MO 63150-5117
Phone (781) 213-3336

Other identifiers 1

IdentifierTypeStateIssuer
8993101MedicaidNC

Other names 2

  • University Dental Associates Doing business as
  • University Dental Associates Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Raymond Garrison DDS PA13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1st
Fl Watlington Hall
Winston Salem, NC 27157
Phone (336) 716-2160

2231 Cloverdale Ave
Winston Salem, NC 27103

2287 Cloverdale Ave
Winston Salem, NC 27103
Phone (336) 749-7208

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1063589711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505117",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631505117",
            "telephone_number": "781-213-3336",
            "fax_number": "781-224-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CLOVERDALE AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032301",
            "telephone_number": "704-547-1970",
            "fax_number": "704-547-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTT F TUCKER, DDS MS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "SENIOR CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8993101",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Dental Associates Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.