Terrance Tyler Receveur, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30.027186 Issued in OH

Practice address

Building NH-100, Floor 2
Camp Lejeune, NC 28542

Phone

(910) 451-2414

NPI assigned

Jun 30, 2023

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1356028385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MCHUGH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285471000",
            "telephone_number": "252-466-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BUILDING NH-100, FLOOR 2",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28542",
            "telephone_number": "910-451-2414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8855 Stoddard Ln",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462171000",
            "country_code": "US",
            "telephone_number": "317-777-1268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RECEVEUR",
        "first_name": "TERRANCE",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie L Raun, PHARMD
• Rebecca Carson Rausa, PA-C
• Angela Marie Raymer, PA-C
• Jenna Reaves, PHARMD
• Nicholas Jordan Reaves, M.D.
• Anthony Micheal Reddick
• Ross Jared Reddock, DDS
• Ashley N Reece, DDS
• Jennifer Reed, MSPT
• Kenneth Reeder, PH.D.

• Dentist in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.