Ty King, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3457 Issued in AR

Practice address

1109 W Chestnut St
Rogers, AR 72756-3529

Phone

(479) 633-8846

Fax

(479) 633-8890

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Ty King DDS

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1720602196
  NPD Authorized official
• Grant J Fowler D.D.S.

  • General Practice Dentistry
  • Rogers, AR
  • NPI 1689221079
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1063555415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 W CHESTNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563529",
            "telephone_number": "479-633-8846",
            "fax_number": "479-633-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W CHESTNUT ST",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727563529",
            "telephone_number": "479-633-8846",
            "fax_number": "479-633-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3457",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@tykingdds.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1109 W Chestnut St",
            "city": "Rogers",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727563529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew C Kincade, M.D.
• Erin Kindy, O.D.
• Brandon Lamar King, PHARMD
• Jeannine King, AT
• Sara L King, LPC
• Austin Kirby
• Kevin Kirkpatrick Sr., LPC
• Erin Elizabeth Kistner, APRN
• Gwendolyn Maurine Kite
• Alma Kivi, M.S. LAC

• Dentist in Rogers, AR
• Providers in Rogers, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.