Tyler Gerard Carron, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2019020686 Issued in MO

Practice address

663 Big Bend Rd
Manchester, MO 63021-7723

Phone

(636) 256-3559

Fax

(636) 256-9879

NPI assigned

Jun 14, 2019

Last updated

Sep 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEABDD/Endpoint/JEABDD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• James H Stanford DDS PC

  • General Practice Dentistry
  • Ballwin, MO
  • NPI 1114020385
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1003476730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 TIMBERSTONE CT",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630217034",
            "telephone_number": "314-677-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 BIG BEND RD",
            "city": "MANCHESTER",
            "state": "MO",
            "postal_code": "630217723",
            "telephone_number": "636-256-3559",
            "fax_number": "636-256-9879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRON",
        "first_name": "TYLER",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-14",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2019020686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Hohn Busch
• Rosemarie Ann Buza, DPT
• Kristen Ann Campbell, DPT
• David W Candy, PT, DPT, OCS, ATC
• Care for You Home Care LLC
• Jeffrey Cavanaugh, DDS
• Cathy Chambliss, FNP
• CM Kinney and Associates, LLC
• Comfort Home Care LLC
• Contemporary Vision Center, LLC (Contemporary Vision Center)

• General Practice Dentistry in Manchester, MO
• Providers in Manchester, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.