Healthcare Provider Details

I. General information

NPI: 1508861162
Provider Name (Legal Business Name): TRACEY RAY HUGHES D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACEY RUTH ELLEN RAY

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 VENETIAN CT STE 1
NAPLES FL
34109-8726
US

IV. Provider business mailing address

2220 VENETIAN CT STE 1
NAPLES FL
34109-8726
US

V. Phone/Fax

Practice location:
  • Phone: 239-231-1865
  • Fax:
Mailing address:
  • Phone: 239-282-4347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0245035
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN29813
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: