Active NPI
Tracy Scott Oliver, DDS
- Dentist
- Virginia Beach, VA
National Provider Identifier
1407997117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401007137
- Practice address
- 2484 N Landing Rd
Suite 114
Virginia Beach, VA 23456-3405 - Phone
- (757) 471-5480
- Fax
- (757) 471-7859
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 0401007137 | VA | Primary |
Addresses
Primary practice location
2484 N Landing Rd
Suite 114
Virginia Beach, VA 23456-3405
Mailing address
1204 Kittiwake CT
Virginia Beach, VA 23451-4923
Phone (757) 422-1317
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 |
|---|---|---|---|
| 0401007137 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461542400000",
"number": "1407997117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1204 KITTIWAKE CT",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234514923",
"telephone_number": "757-422-1317",
"fax_number": "757-961-2771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2484 N LANDING RD",
"address_2": "SUITE 114",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234563405",
"telephone_number": "757-471-5480",
"fax_number": "757-471-7859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "TRACY",
"middle_name": "SCOTT",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2016-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401007137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.