Organization Active NPI

Bruce R Tripp Jr DDS PA

  • Dentist
  • Greenville, NC
National Provider Identifier
1699047167
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5112 Issued in NC
Legal business name
BRUCE R TRIPP JR DDS PA
Practice address
5076 US 264 E
Greenville, NC 27834-5804
Phone
(252) 752-7880
Fax
(252) 752-9602
NPI assigned
Jan 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Authorized official

Name
Dr. Bruce Ray Tripp Jr., DDS
Title
Owner
Phone
(252) 752-7880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5112 NC Primary
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X NC

Addresses

Primary practice location

5076 US 264 E
Greenville, NC 27834-5804

Mailing address

5076 US 264 E
Greenville, NC 27834-5804
Phone (252) 752-7880

Other identifiers 1

IdentifierTypeStateIssuer
5919749MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1699047167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5076 US 264 E",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345804",
            "telephone_number": "252-752-7880",
            "fax_number": "252-752-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5076 US 264 E",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345804",
            "telephone_number": "252-752-7880",
            "fax_number": "252-752-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE R TRIPP JR DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-752-7880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "5112",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5919749",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.