Trent Tucker, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30-024376 Issued in OH

Practice address

7325 Far Hills Ave
Dayton, OH 45459-4415

Phone

(937) 439-1606

NPI assigned

May 14, 2009

Last updated

Apr 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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 Jul 1, 2019 through Jul 1, 2027

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Dayton Oral & Maxillofacial Surgery Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Dayton, OH
  • NPI 1942694583
  Authorized official Same address or phone
• Michael a Herman DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Dayton, OH
  • NPI 1942396791
  NPD (past)

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1336373679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 SEA PINES LN",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454583321",
            "telephone_number": "419-680-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7325 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594415",
            "telephone_number": "937-439-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TRENT",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30-024376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylan Tucker
• Morgan Tucker
• Moriah Diane Tucker, R.N.
• Saleem Todd Tucker
• Stella Tucker, RN
• Candice Tudor, CDCA
• Tuff Minds
• Richard Tuff, CNP
• Laura Jill Tully, MD
• Melvis Menyam Tumasang

• Oral and Maxillofacial Surgery (Dentist) in Dayton, OH
• Providers in Dayton, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.