Individual provider Active NPI

Jessica Leigh Tucker, D.D.S.

  • Pediatric Dentistry
  • Richmond, VA
National Provider Identifier
1649651993
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
0442000242 Issued in VA
Practice address
6900 Forest Ave
Suite 110
Richmond, VA 23230-1729
Phone
(804) 893-8692
Fax
(804) 285-1292
NPI assigned
Jun 12, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 0442000242 VA Primary

Addresses

Primary practice location

6900 Forest Ave
Suite 110
Richmond, VA 23230-1729

Mailing address

6900 Forest Ave
Suite 110
Richmond, VA 23230-1729
Phone (804) 893-8692

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
0442000242VAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1649651993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 FOREST AVE",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301729",
            "telephone_number": "804-893-8692",
            "fax_number": "804-285-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 FOREST AVE",
            "address_2": "SUITE 110",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301729",
            "telephone_number": "804-893-8692",
            "fax_number": "804-285-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-12",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0442000242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; 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.