Individual provider Active NPI

Danielle M Gough Tooker, DMD

  • General Practice Dentistry
  • Leland, NC
National Provider Identifier
1174015424
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11036 Issued in NC
Practice address
1215 W Gate Dr Ste 180
Leland, NC 28451-0437
Phone
(910) 663-4405
NPI assigned
Jun 2, 2018
Last updated
Jun 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11036 NC Primary

Addresses

Primary practice location

1215 W Gate Dr Ste 180
Leland, NC 28451-0437

Mailing address

PO Box 156
Deep Run, NC 28525-0156

Other practice location 1

711 N Brown St
Chadbourn, NC 28431-1307
Phone (252) 361-8062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1527897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1174015424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 156",
            "city": "DEEP RUN",
            "state": "NC",
            "postal_code": "285250156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W GATE DR STE 180",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284510437",
            "telephone_number": "910-663-4405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 N Brown St",
            "address_purpose": "LOCATION",
            "city": "Chadbourn",
            "state": "NC",
            "postal_code": "284311307",
            "country_code": "US",
            "telephone_number": "252-361-8062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUGH TOOKER",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-02",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.