J D Rucker Jr DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

Z1899 Issued in SC

Legal business name

J D RUCKER JR DDS PA

Practice address

145 Center Street
Chester, SC 29704-2704

Phone

(803) 377-1157

Fax

(803) 385-6898

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

James D Rucker Jr., DDS

Title

Owner President

Phone

(803) 377-1157

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437284072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297042704",
            "telephone_number": "803-377-1157",
            "fax_number": "803-385-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CENTER STREET",
            "city": "CHESTER",
            "state": "SC",
            "postal_code": "297042704",
            "telephone_number": "803-377-1157",
            "fax_number": "803-385-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J D RUCKER JR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "803-377-1157",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "Z1899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZA9826",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Chester, SC
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.