Randall D Tucker, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

15913 Issued in MA

Practice address

166 North Main Street
Andover, MA 01810

Phone

(978) 475-8656

Fax

(978) 470-2788

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598817694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 NORTH MAIN STREET",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-8656",
            "fax_number": "978-470-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 NORTH MAIN STREET",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "01810",
            "telephone_number": "978-475-8656",
            "fax_number": "978-470-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "RANDALL",
        "middle_name": "D",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MA",
            "license": "15913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Ann Trombly, RN
• Diane Jeanette True, LICENSED INDEPENDENT
• Trustees of Phillips Academy
• Julie Elizabeth Tucci, R.D.
• Sheila Marie Tucke, LICSW
• Sheila E. Tucker, D.M.D.
• Anthony E Turiano, MD
• Delaney Grace Turner, DMD
• Uberdoc, Inc.
• Tien T. Ung, LICSW

• Prosthodontics in Andover, MA
• Providers in Andover, MA by specialty
• Prosthodontics in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.