Active NPI
Gerald W Tuck, DDS
- Dentist
- Great Falls, MT
National Provider Identifier
1275644841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1562
- Practice address
- 900 10TH Ave NW
Great Falls, MT 59404-1747 - Phone
- (406) 761-1365
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1562 | MT | Primary |
Addresses
Primary practice location
900 10TH Ave NW
Great Falls, MT 59404-1747
Mailing address
900 10TH Ave NW
Great Falls, MT 59404-1747
Phone (406) 761-1365
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94276 | Other | MT | DELTA DENTAL |
| 11-5570 | Medicaid | MT | |
| 4029 | Other | MT | BLUS CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1562 | MT | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275644841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 10TH AVE NW",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "594041747",
"telephone_number": "406-761-1365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 10TH AVE NW",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "594041747",
"telephone_number": "406-761-1365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCK",
"first_name": "GERALD",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MT",
"license": "1562",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL",
"identifier": "94276",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11-5570",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUS CROSS BLUE SHIELD",
"identifier": "4029",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Great Falls, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.