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DR. SHAVON TUCKER DDS
NPI 1316780422
Dentist in Milwaukee, WI

Active since June 17, 2024PECOS Enrolled
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212(414) 267-2670(414) 562-8432 Get Directions Write a Review

NPPES record last updated: July 17, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Shavon Tucker Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHAVON TUCKER DDS (NPI 1316780422) is an individual dentist in Milwaukee, Wisconsin, licensed in Wisconsin (6001651-15) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1316780422
Entity TypeIndividualFemale
Primary Taxonomy122300000X
Provider Legal NameDR. SHAVON TUCKERCredential: DDS
Location Address2555 N DR MARTIN LUTHER KING JR DRMilwaukee, WI 53212-2709
Mailing Address2555 N Dr Martin Luther King Jr DrMilwaukee, WI 53212-2709 · (414) 267-2670 · Fax (414) 562-8432
Phone(414) 267-2670
Fax(414) 562-8432
Sole ProprietorNo
Enumeration DateJune 17, 2024
Last NPPES UpdateJuly 17, 2025
NPPES CertifiedJuly 15, 2025
✔ NPI 1316780422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in WI · 6001651-15✔ Licensed in MO · 2024022265
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 6001651-15 (WI)
2555 N DR MARTIN LUTHER KING JR DR, Milwaukee, WI 53212
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Secondary Practice Locations 2

Location 11153 NE Rice RdLees Summit, MO 64086-6788 · Phone (816) 477-7070
Location 28200 W Silver Spring DrMilwaukee, WI 53218-2552 · Phone (414) 267-2671 · Fax (414) 464-7258

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shavon Tucker Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shavon Tucker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Milwaukee Health Services, Inc.
Same address
Federally Qualified Health Center (FQHC)
2555 N DR MARTIN LUTHER KING DR
Milwaukee, WI 53212
  • Reassigned Medicare billing, Wisconsin enrollment
  • 86 clinicians in this Medicare group
NPI 1518005818 (414) 267-2021

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TITO LAMONT IZARD M.D.
Family Medicine
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
MORGAN MOREAU DMD
Dentist
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 267-2670
SHARNELL MARIE SANDLIN NP
Nurse Practitioner
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
FLORA AGYEI APNP
Nurse Practitioner (Psychiatric/Mental Health)
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
DR. ALLYSON CASELBERRY DMD
Dentist (General Practice)
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
JOSEPH FRANECKI PA
Physician Assistant
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
SHARON RENEE LEE
Counselor (Professional)
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080
LASHONDA MIRANDA APSW, LCSW
Social Worker (Clinical)
2555 N DR MARTIN LUTHER KING JR DR
MILWAUKEE, WI 53212
Milwaukee County (414) 372-8080

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shavon Tucker's NPI number?

The NPI number for Shavon Tucker is 1316780422. It was assigned to this individual provider in the NPPES registry on June 17, 2024.

Where is Shavon Tucker located?

Shavon Tucker practices at 2555 N Dr Martin Luther King Jr Dr, Milwaukee, WI 53212. The listed phone number is (414) 267-2670.

What is Shavon Tucker's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Shavon Tucker enrolled in Medicare?

Yes. Shavon Tucker is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shavon Tucker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shavon Tucker reassigns Medicare benefits to Milwaukee Health Services, Inc. (Milwaukee, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shavon Tucker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shavon Tucker accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Shavon Tucker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shavon Tucker was last updated on July 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.