DR. MYRON R TUCKER (NPI# 1427022441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427022441 |
| Entity Type | Individual |
| Full Name | DR. MYRON R TUCKER |
| Credential | DDS |
| Practice Address |
411 Billingsley Rd Suite 105 Charlotte NC 28211-1066 |
| Practice Telephone | 7043473900 |
| Practice Fax Number | 7043470133 |
| Mailing Telephone | 7043473900 |
| Mailing Fax Number | 7043470133 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2007-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5193 | NC | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 899853B | 05 | |
| NC | BCBS | 9853B | 01 |
| Street Address |
411 BILLINGSLEY RD SUITE 105 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28211-1066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235126517 | Carolinas Cancer Care Pa | Specialist | 411 Billingsley Rd, Suite 103, Charlotte, NC 28211-1066 | 2005-10-03 |
| 1073979431 | Bunny Yun | Dentist | 411 Billingsley Rd, 102, Charlotte, NC 28211-1046 | 2016-01-14 |
| 1194086744 | Logan Elizabeth Webb | Dentist | 411 Billingsley Rd, Suite 106, Charlotte, NC 28211-1046 | 2012-05-30 |
| 1043580681 | Charlotte Mecklenburg Hospital Authority | Internal Medicine | 411 Billingsley Rd, Suite 103, Charlotte, NC 28211-1046 | 2012-01-12 |
| 1881992659 | R K Yeager & Assoc Dds Pa & S | Dentist | 411 Billingsley Rd, Suite 102, Charlotte, NC 28211-1046 | 2011-03-03 |
| 1740590074 | Carolinas Physicians Network Inc | Internal Medicine | 411 Billingsley Rd, Suite 103, Charlotte, NC 28211-1046 | 2010-10-20 |
| 1598959538 | Oms Facility Services LLC | Dentist | 411 Billingsley Rd, Suite 105, Charlotte, NC 28211-1046 | 2007-09-04 |
| 1649475005 | John Carson Nale | Oral & Maxillofacial Surgery | 411 Billingsley Rd, Suite 105, Charlotte, NC 28211-1046 | 2007-06-18 |
| 1962612259 | Stanley Michalski IIi | Dentist | 411 Billingsley Rd, Suite 102, Charlotte, NC 28211-1046 | 2007-05-23 |
| 1518176668 | Thomas Pinnavaia | Dentist | 411 Billingsley Rd, Suite 102, Charlotte, NC 28211-1046 | 2007-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
| 1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
| 1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
| 1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
| 1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
| 1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
| 1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
| 1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
| 1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
| 1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
| Find all providers in zip 28211 | ||||
| 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 |
|---|---|---|---|---|
| 1003296831 | Jesse Eric Ricciuti | Dentist | 10042 Park Cedar Dr Ste B, Charlotte, NC 28210 | 2015-06-07 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1619314556 | George Yi Jaan Soung | Dentist | 5700 University Pointe Blvd Ste 104, Charlotte, NC 28262-5026 | 2013-06-02 |
| 1013278696 | Andrew Henry | Dentist | 8840 Blakeney Professional Dr Ste 300, Charlotte, NC 28277-6749 | 2012-05-31 |
| 1861703183 | Carrie A Baldwin | Dentist | 1601 Abbey Pl Ste 220, Charlotte, NC 28209-3825 | 2010-07-01 |
| 1407011927 | Karthik Kanakasundaram Naidu | Dentist | 5700 University Pointe Blvd, Suite 104, Charlotte, NC 28262-5026 | 2008-07-24 |
| 1861650095 | Mid Michigan Oral Surgery | Dentist | 110 N Cochran Ave, Charlotte, MI 48813-1508 | 2008-05-23 |
| 1942474077 | Waheed V Mohamed | Dentist | 411 Billingsley Rd., Suite 105, Charlotte, NC 28211 | 2008-04-18 |
| 1659543155 | John Omalley | Dentist | 2007 Randolph Rd, Charlotte, NC 28207-1233 | 2008-03-25 |
| 1679756597 | Robert L Seymour Dds Pa | Dentist | 2711 Randolph Rd Ste 510, Charlotte, NC 28207-2027 | 2007-12-13 |
| Find all providers in CHARLOTTE | ||||
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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.