Monique Ernestine Lois Davidson-Tucker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

042757-1 Issued in NY

Practice address

13417 Francis Lewis Blvd
Laurelton, NY 11413-2539

Phone

(718) 525-4089

Fax

(718) 525-5696

NPI assigned

May 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Previously, effective Sep 16, 2016 through Sep 16, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447468053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13417 FRANCIS LEWIS BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132539",
            "telephone_number": "718-525-4089",
            "fax_number": "718-525-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13417 FRANCIS LEWIS BLVD",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132539",
            "telephone_number": "718-525-4089",
            "fax_number": "718-525-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON-TUCKER",
        "first_name": "MONIQUE",
        "middle_name": "ERNESTINE LOIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042757-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01995775",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree Cumbermack
• Donyale Cummings
• Paul M D'Amore, PHARMD
• Winsome Elise Daley
• Gail Miriam David
• Marcia Eleise Davidson, LPN
• Shelia Deabreu
• Marly Degraff Khan, LPN
• Kaylon Demendonca
• Charmaine Dennis

• Dentist in Laurelton, NY
• Providers in Laurelton, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.