SCOTT A. PUCKETT (NPI# 1215998851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215998851 |
| Entity Type | Individual |
| Full Name | SCOTT A. PUCKETT |
| Credential | DDS |
| Practice Address |
1665 Alex Dr Wilmington OH 45177 |
| Practice Telephone | 9373828020 |
| Practice Fax Number | 9373828020 |
| Mailing Telephone | 9373828020 |
| Mailing Fax Number | 9373828020 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
30-021139 | OH | Dental Providers |
| X | 204E00000X | Oral & Maxillofacial Surgery | 30-021139 | OH | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578186656 | Scott Louis Puckett | Student in an Organized Health Care Education/Training Program | 4502 E 41st St, Tulsa, OK 74135-2536 | 2020-05-22 |
| Street Address |
1665 ALEX DR |
| City | WILMINGTON |
| State | OH |
| Zip Code | 45177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710542220 | Kratzer Pharmacy Inc. | Pharmacy | 187 W Locust St, Wilmington, OH 45177 | 2019-05-09 |
| 1639642754 | Jerrica Kimber Smith | Physical Therapy Assistant | 175 Cape May Dr., Therapy Suite, Wilmington, OH 45177 | 2019-01-11 |
| 1083187280 | Heather Freytag | Physical Therapy Assistant | 175 Cape May Drive, Wilmington, OH 45177 | 2019-01-10 |
| 1740780865 | Greater Tomorrow Wellness, LLC | Physician Assistant | 1097 W Locust St, Wilmington, OH 45177 | 2018-02-15 |
| 1144632431 | Orion Rehabilitation Center, Inc. | Day Training, Developmentally Disabled Services | 4595 State Route 730, Wilmington, OH 45177 | 2014-05-21 |
| 1841546975 | Kathleen Michelle Miller | Nurse Practitioner | 610 West Main Street, Emergency Department, Wilmington, OH 45177 | 2012-07-26 |
| 1952693590 | John K Loudermilk Inc. | Dentist | 260 W. Locust St., Wilmington, OH 45177 | 2011-05-13 |
| 1619209475 | Premier Health Care LLC | Clinic/Center | 2845 Progress Way, Wilmington, OH 45177 | 2010-02-04 |
| 1417179474 | Larry Alan Howard | Specialist/Technologist | Wilmington College, 1870 Quaker Way, Box 1246, Wilmington, OH 45177 | 2007-05-02 |
| 1659494425 | Alan Robert Thompson | Chiropractor | 39 North South Street, Wilmington, OH 45177 | 2007-04-09 |
| Find all providers in zip 45177 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689224495 | Graham H. Wilson, Dds, Pa | Dentist | 7971 Market Street, Wilmington, NC 28411-9383 | 2019-09-13 |
| 1912200031 | John E Hickory | Dentist | 412 Ann St, Wilmington, NC 28401-4662 | 2010-12-11 |
| 1184941189 | Conrad, Arne', Lombardo, & Krupa, D.d.s, P.a. | Dentist | 7971 Market St, Wilmington, NC 28411-9383 | 2010-04-29 |
| 1689998304 | Gregg A. Lombardo, D.d.s., P.a. | Dentist | 1510 Medical Center Drive, Wilmington, NC 28401-7506 | 2010-03-24 |
| 1437321296 | Brady J. Semmel, Dmd, Md, Pa | Dentist | 1422 Commonwealth Drive, Wilmington, NC 28403-0302 | 2008-04-01 |
| 1811174352 | Douglas F. Degroote, Dds | Dentist | 2250 Shipyard Blvd Ste 15, Wilmington, NC 28403-8070 | 2008-01-28 |
| 1801001516 | David Dieu | Dentist | 1202 Foulk Road, Wilmington, DE 19803 | 2007-05-14 |
| 1043437825 | Michael Lee Hasson | Dentist | 1221 Floral Pkwy Ste 101, Wilmington, NC 28403-6235 | 2007-04-20 |
| 1306971882 | Shawn Conrad | Dentist | 1510 Medical Center Dr, Wilmington, NC 28401-7506 | 2007-02-23 |
| 1770639171 | Michael S. Booth | Dentist | 1305 Physicians Dr., Wilmington, NC 28401-7352 | 2007-01-26 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 45177 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.