Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shavon Tucker, DDS

Individual provider Dentist · NPI 1316780422

Dr. Shavon Tucker, DDS is a Dentist in Milwaukee, Wisconsin. Qualified in 2024, 2 years ago. Works from 3 locations. Licensed in Missouri and Wisconsin.

Years since qualifying
2
Licensed in
MO, WI
In the registry since
2024
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2555 N Dr Martin Luther King Jr Dr
Milwaukee, WI 53212-2709
Phone: (414) 267-2670
Fax: (414) 562-8432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1153 Ne Rice Rd, Lees Summit, MO 64086-6788 — (816) 477-7070
  • 8200 W Silver Spring Dr, Milwaukee, WI 53218-2552 — (414) 267-2671

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 6001651-15 (WI)
Dentist Taxonomy 122300000X · Licence 2024022265 (MO)
General Practice Dentistry Taxonomy 1223G0001X · Licence 6001651-15 (WI)

Record details

NPI number1316780422
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedJune 17, 2024
Last updated in NPPESJuly 17, 2025
Certification dateJuly 15, 2025
Mailing address2555 N Dr Martin Luther King Jr Dr, Milwaukee, WI 53212-2709

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDENTIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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