Travis Craig Tucker, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

100019 Issued in CA

Practice address

1425 Victor Ave Ste a
Redding, CA 96003-4857

Phone

(530) 222-0920

Fax

(530) 222-0921

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Travis C Tucker, DMD., Inc.

  • Dentist
  • Redding, CA
  • NPI 1306320171
  NPD Authorized official

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1790165702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 VICTOR AVE STE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034857",
            "telephone_number": "530-222-0920",
            "fax_number": "530-222-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 VICTOR AVE STE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034857",
            "telephone_number": "530-222-0920",
            "fax_number": "530-222-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "TRAVIS",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100019",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040406",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040406",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Bruce Trustman, CP
• Justina Jennan Tseng, MD
• Tsuchistein Dental Care Inc
• Catherine Cecilia Tucker, LMFT
• Maite Karina Tucker
• John C Tuggle Jr.
• Laura Tulledo-Johnson, R1417930121
• Victoria Tumino, MSW
• Tin Tun, M.D.
• Mara Tupper, LVN

• General Practice Dentistry in Redding, CA
• Providers in Redding, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.