Tyler James Banachowski, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

DN24505 Issued in FL

Practice address

2223 Sarno Rd
Melbourne, FL 32935-3003

Phone

(321) 425-2018

NPI assigned

Mar 12, 2012

Last updated

Jul 6, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Locations

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.

• New Image Maxillofacial LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Melbourne, FL
  • NPI 1194767707
  Medicare reassignment NPD
• Coast Florida P.a.

  dba Coast Dental-Gandy

  • Dentist
  • St Petersburg, FL
  • NPI 1457927857
  NPD (past)
• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1033484944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2223 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353003",
            "telephone_number": "321-425-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2223 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353003",
            "telephone_number": "321-425-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACHOWSKI",
        "first_name": "TYLER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24505",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DN24505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Dian Baldwin
• Sara Jane Ball, PA-C
• Houria Balmakhtar
• Apryl Balmir, OTR/L
• Olivia O Bamishigbin, NP-C, FNP-BC
• Rodel Umlas Banal, M.D.
• Amy Faye Bankey, BSN, RN
• Rashenett Shantrell Banks
• Parvesh K. Bansal, M.D.
• Ridhi Bansal, MD

• Oral & Maxillofacial Surgery (D.M.D.) in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.