NPIMap

Organization Active NPI

R. Gray Tuttle III, DDS,PLLC

  • General Practice Dentistry
  • Winston-Salem, NC
National Provider Identifier
1881620375
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103620 Issued in NC
Legal business name
R. GRAY TUTTLE III, DDS,PLLC
Practice address
1341 Westgate Center Dr
Suite a
Winston-Salem, NC 27103-2934
Phone
(336) 768-1712
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Reuben Gray Tuttle III, DDSNPI 1356370670
Title
DDS PLLC
Phone
(336) 768-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 103620 NC Primary

Addresses

Primary practice location

1341 Westgate Center Dr
Suite a
Winston-Salem, NC 27103-2934

Mailing address

1341 Westgate Center Dr
Suite a
Winston-Salem, NC 27103-2934
Phone (336) 768-1712

Other identifiers 1

IdentifierTypeStateIssuer
98655OtherNCBCBSNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881620375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 WESTGATE CENTER DR",
            "address_2": "SUITE A",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271032934",
            "telephone_number": "336-768-1712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 WESTGATE CENTER DR",
            "address_2": "SUITE A",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271032934",
            "telephone_number": "336-768-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. GRAY TUTTLE III, DDS,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "GRAY",
        "authorized_official_title_or_position": "DDS PLLC",
        "authorized_official_telephone_number": "336-768-1712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "103620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "98655",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.