Individual provider Active NPI

Tanner Welby Dice, DMD

  • Dentist
  • Raleigh, NC
National Provider Identifier
1750010237
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14649 Issued in NC
Practice address
3840 Ed Dr Ste 120
Raleigh, NC 27612-8097
Phone
(859) 432-0047
NPI assigned
Jun 9, 2022
Last updated
Jul 7, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28479 FL
Dentist 122300000X 14649 NC Primary
General Practice Dentistry 1223G0001X 38422 TX

Addresses

Primary practice location

3840 Ed Dr Ste 120
Raleigh, NC 27612-8097

Mailing address

3840 Ed Dr Ste 120
Raleigh, NC 27612-8097
Phone (859) 432-0047

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

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Dental of Southlake, PLLC CurrentSince Aug 3, 2025 Accepting new patients
Tanner Dice, DMD, PA Past Accepting new patients

Locations

1845 E Southlake Blvd
#144
Southlake, TX 76092
Phone (817) 554-1122

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1750010237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 ED DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128097",
            "telephone_number": "859-432-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 ED DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128097",
            "telephone_number": "859-432-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICE",
        "first_name": "TANNER",
        "middle_name": "WELBY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "28479",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "14649",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.