Individual provider Active NPI

Vance Wesley Tutor, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Memphis, TN
National Provider Identifier
1396031043
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS0000010673 Issued in TN
Practice address
766 S. White Station Rd. Ste 1
Memphis, TN 38117
Phone
(901) 685-8090
Fax
(901) 684-1662
NPI assigned
Jun 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3829 AR
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS0000010673 TN Primary

Addresses

Primary practice location

766 S. White Station Rd. Ste 1
Memphis, TN 38117

Mailing address

766 S. White Station Rd. Ste 1
Memphis, TN 38117
Phone (901) 685-8090

Other identifiers 1

IdentifierTypeStateIssuer
187779608OtherARARKIDS, MEDICAID

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

LicenseStateTypeSpecialty
3829ARMDDentist
DS0000010673TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Smith & Ivers CurrentSince Jun 25, 2023 Accepting new patients
DRS Albright, Smith & Peck PastSince Feb 9, 2020 Accepting new patients

Locations

766 S White Station Rd
Ste 1
Memphis, TN 38117
Phone (901) 685-8090

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1396031043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 S. WHITE STATION RD. STE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-685-8090",
            "fax_number": "901-684-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "766 S. WHITE STATION RD. STE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38117",
            "telephone_number": "901-685-8090",
            "fax_number": "901-684-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTOR",
        "first_name": "VANCE",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-21",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3829",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000010673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKIDS, MEDICAID",
            "identifier": "187779608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.