Individual provider Active NPI

Steven J Tucker, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mebane, NC
National Provider Identifier
1902461684
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
14484 Issued in NC
Practice address
1107 S Fifth St Ste 250
Mebane, NC 27302-9896
Phone
(919) 563-2873
NPI assigned
May 7, 2019
Last updated
Oct 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 14484 NC Primary

Addresses

Primary practice location

1107 S Fifth St Ste 250
Mebane, NC 27302-9896

Mailing address

1107 S Fifth St Ste 250
Mebane, NC 27302-9896
Phone (919) 563-2873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240508002400 MA Practitioner - Oral Surgery 3678808490 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14484NCMDOral and Maxillofacial Surgery (Dentist)
12485CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Peabody Oral Surgery Inc. Oral and Maxillofacial Surgery CurrentSince Mar 13, 2024 Accepting new patients
Melrose Wakefield Oral Surgery Inc. Oral and Maxillofacial Surgery Past Accepting new patients

Locations

6 Essex Center Dr
Ste 112A
Peabody, MA 01960
Phone (781) 323-4345

6 Essex Dr
Ste 112
Peabody, MA 01960
Phone (978) 531-1450

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": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1902461684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 250",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029896",
            "telephone_number": "919-563-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 250",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029896",
            "telephone_number": "919-563-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "14484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mebane, NC

Sources for this page

Verify at the official NPI Registry.