Timothy Lee Tucker, DDS
Individual provider Active NPI General Practice Dentistry · Drexel, NC
NPI 1942227491 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1942227491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 4124 (NC)
- Practice address
- 300 South Main Street
Drexel, NC 28619-0848 - Phone
- (828) 437-6135
- Fax
- (828) 430-8128
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4124 | NC | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4124 | NC | Yes |
Addresses
Primary practice location
300 South Main Street
Drexel, NC 28619-0848
Mailing address
PO Box 848
Drexel, NC 28619-0848
Phone (828) 437-6135
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98598 | Other | NC | BLUE CROSS BLUE SHIELD |
| 8998598 | Medicaid | NC |
Other providers in Drexel, NC
- Arvis Bennett Boughman
- Destiny Management Incorporated
- Focus Behavioral Health Services, LLC
- Handi-Care, Inc.
- Handi-Care, Inc.
- Jason Carlton Webb
All providers in Drexel, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.