Jason R Tucker, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60111978 Issued in WA

Practice address

101 North 6TH Street
Brewster, WA 98812

Phone

(509) 689-3789

Fax

(509) 689-7647

NPI assigned

Sep 23, 2009

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)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Health Centers

  • Dental Clinic/Center
  • Brewster, WA
  • NPI 1649409186
  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1982938924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTH 6TH STREET",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "98812",
            "telephone_number": "509-689-3789",
            "fax_number": "509-689-7647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60111978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Smith, RN
• Lisa Diane Sonneman, P.T.
• Boyd Luwayne Stout, D.D.S.
• Cierra Sullivan
• Gordon Chris Tingle, LMT
• James G Wallace Jr., M.D.
• Brandon Watson, O.D.
• Wenatchee Valley Hospital
• Yvonne M Zoretic, OTR/L

• Dentist in Brewster, WA
• Providers in Brewster, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.