Dennis Maxwell Tucker, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

D11410 Issued in MN

Practice address

622 Roosevelt Rd
Ste 180
Saint Cloud, MN 56301-6153

Phone

(320) 259-5078

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436054400000",
    "number": "1962577338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 ROOSEVELT RD 180",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016361",
            "telephone_number": "320-259-5078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 ROOSEVELT RD",
            "address_2": "STE 180",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563016153",
            "telephone_number": "320-259-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DENNIS",
        "middle_name": "MAXWELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2015-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D11410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Trutwin, RN
• Jyh-Yau Tsaur, MD
• Andrea Ann Tschida
• Kathryn Marie Tschida
• Sabina A. Tuabu
• Kayla Tucker, RBT
• Jessica Elaine Tunnell, RBT
• James Rudolph Tuorila
• Anne Tuoy-Giel, FNP
• Alexis Hope Turn, OD

• Endodontics in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2015; 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.