Thomas L Tyree, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2421 Issued in WV

Practice address

1702 Oak St
Kenova, WV 25530-1120

Phone

(304) 453-6765

Fax

(304) 453-1695

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Thomas L Tyree DDS Inc

  • General Practice Dentistry
  • Kenova, WV
  • NPI 1376612887
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033288691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 OAK ST",
            "city": "KENOVA",
            "state": "WV",
            "postal_code": "255301120",
            "telephone_number": "304-453-6765",
            "fax_number": "304-453-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 OAK ST",
            "city": "KENOVA",
            "state": "WV",
            "postal_code": "255301120",
            "telephone_number": "304-453-6765",
            "fax_number": "304-453-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYREE",
        "first_name": "THOMAS",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136238000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL PROVIDER",
            "identifier": "0135603",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tzia Myria Tomblin
• Tri-State Cytology LLC
• Michelle Trimboli
• Lois Jean Trogdon
• Rachel Turnwald
• Ashley Dawn Vannatter, PRSS
• Jessica Renee Vaughn
• Patricia Walker
• Virginia Walker
• Bethany Gay Wallace

• General Practice Dentistry in Kenova, WV
• Providers in Kenova, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.