Carlton D Rucker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3742 Issued in SC

Practice address

575 Springcrest Dr Ste a
Fort Mill, SC 29715-7324

Phone

(803) 547-1888

Fax

(803) 547-8533

NPI assigned

May 5, 2006

Last updated

Jun 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dominguez & Rucker Family Dentistry LLC

  • Dentist
  • Fort Mill, SC
  • NPI 1508023649
  NPD (past)
• Rucker Dentistry

  • General Practice Dentistry
  • Lancaster, SC
  • NPI 1780898460
  NPD (past)
• Skyla Inc.

  • Dental Clinic/Center
  • Rock Hill, SC
  • NPI 1003320003
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1841248382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 SPRINGCREST DR STE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157324",
            "telephone_number": "803-547-1888",
            "fax_number": "803-547-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 SPRINGCREST DR STE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157324",
            "telephone_number": "803-547-1888",
            "fax_number": "803-547-8533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 Chesterfield Ave",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "SC",
            "postal_code": "297203508",
            "country_code": "US",
            "telephone_number": "803-283-9969",
            "fax_number": "803-283-9907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "CARLTON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "3742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3742",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rose Pediatric Therapy, LLC
• Kelley Ann Rosebrock, FNP
• Kristy Rossi
• Holley Rowland
• Melinda Rozear, RBT
• Mary Runyon, ATC
• Rudiko Rusia, MD
• Hannah L Russell, PHARMD
• Brandi Bence Ruth, BCBA
• Kelly Williams Rydell, FNP

• Dentist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.