Tyler A. Graham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1549 Issued in WY

Practice address

325 W Main St Ste G
Riverton, WY 82501-3448

Phone

(307) 856-5210

NPI assigned

May 23, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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 and National Provider Directory roles.

• Graham Family Dental

  • Dental Clinic/Center
  • Riverton, WY
  • NPI 1780207811
  NPD Authorized official

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

{
    "created_epoch": "1590192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590192000000",
    "number": "1053934182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W MAIN ST STE G",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W MAIN ST STE G",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013448",
            "telephone_number": "307-856-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TYLER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-23",
        "last_updated": "2020-05-23",
        "certification_date": "2020-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "grahamfamilydental20@gmail.com",
            "affiliation": "N",
            "address_1": "325 W Main St Ste G",
            "city": "Riverton",
            "state": "WY",
            "country_code": "US",
            "postal_code": "825013448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Roger L Gose, MD
• Graham Family Dental
• Joshua Leon Graham, PHARMD
• McKenzie Ann Graham, PHARMD, RPH
• Tyler Graham, PT, DPT
• Grand Valley in-Home 24 HR Nursing LLC (Grand Valley Nursing LLC)
• Jodi Grant
• Jeffrey R Gray, DC
• Chelcy Green
• Joshua Green, RPH

• General Practice Dentistry in Riverton, WY
• Providers in Riverton, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2020; 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.