Taylor Tracy Duckworth, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

10808 Issued in TN

Practice address

324 22ND Ave N
Nashville, TN 37203-1842

Phone

(615) 329-4401

Fax

(615) 321-6175

NPI assigned

Jun 19, 2018

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 TN

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

Specialty

Oral Surgery

Education

University of Arizona College of Medicine - Phoenix, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McKenzie Oral and Facial Surgery PLLCGroup PAC ID 5991038523, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• McKenzie Oral and Facial Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickson, TN
  • NPI 1922568666
  Medicare reassignment Care Compare group NPD
• Maximize Oral Surgery Management

  dba Mid-State Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Dickson, TN
  • NPI 1043921851
  NPD (past)
• TN Dental Professionals II PC

  • Dentist
  • Nashville, TN
  • NPI 1417300617
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1689168064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031842",
            "telephone_number": "615-329-4401",
            "fax_number": "615-321-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031842",
            "telephone_number": "615-329-4401",
            "fax_number": "615-321-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKWORTH",
        "first_name": "TAYLOR",
        "middle_name": "TRACY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "10808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernard John Dubray Jr., M.D.
• Mary L Dubuisson, RN
• John Matthew Ducey, M.D.
• Tommy J. Ducklo, OD
• Kathryn Duckworth, MD
• Dawn E. Ducote, LCSW
• Julian Christopher Duda, M.D.
• Martha E Dudek, MS LCGC
• Rosemarie A Dudenhofer, M.D.
• Andrew Stephens Dudley

• Dentist in Nashville, TN
• Providers in Nashville, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.