Tucker & Allen-Johnson DDS PA

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7497 Issued in NC

Legal business name

TUCKER & ALLEN-JOHNSON DDS PA

Doing business as

Smile Junction Pediatric Dentistry

Practice address

2975 Crouse Lane
Burlington, NC 27215-8833

Phone

(336) 538-1608

NPI assigned

Oct 1, 2007

Last updated

Jan 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nikki Giovonne Tucker, DDS

Title

President

Phone

(336) 538-1608

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Smile Junction Pediatric Dentistry Doing business as

Locations

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1952598310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2975 CROUSE LANE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-538-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2975 CROUSE LANE",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272158833",
            "telephone_number": "336-538-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUCKER & ALLEN-JOHNSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "NIKKI",
        "authorized_official_middle_name": "GIOVONNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-538-1608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "7497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89902TV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA HEALTH CHOICE/INDIVIDUAL",
            "identifier": "092TV",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA HEALTH CHOICE/INDIVIDUAL",
            "identifier": "0902UH",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA HEALTH CHOICE/GROUP",
            "identifier": "019VY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Junction Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Burlington, NC
• Providers in Burlington, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.