MEDICARE: DR. TRACEY RAY HUGHES D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9380	CO
2	1223G0001X	General Practice Dentistry	019.034501	IL
3	1223G0001X	General Practice Dentistry	0245035	IA
4	1223G0001X	General Practice Dentistry	DN29813	FL

General Provider Information

NPI Number	:	1508861162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRACEY RAY HUGHES D.D.S.

Provider Business Mailing Address
First Line	:	9910 ESTERO OAKS DR APT 202
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33967-5268
Country	:	US
Telephone Number	:	720-335-3566
Fax Number	:

Provider Business Practice Location Address
First Line	:	9910 ESTERO OAKS DR APT 202
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33967-5268
Country	:	US
Telephone Number	:	720-335-3566
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	02/24/2026

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