Robert P. Tyrrell, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

813 Issued in WY

Legal business name

ROBERT P. TYRRELL, D.D.S.

Practice address

1702 Antelope Street
Kemmerer, WY 83101-3900

Phone

(307) 877-4715

Fax

(307) 877-3475

NPI assigned

Jun 17, 2015

Last updated

Jun 17, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rachel Wood

Title

Office Manager

Phone

(307) 877-4715

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert P. Tyrrell, DDS

  • General Practice Dentistry
  • Kemmerer, WY
  • NPI 1952499360
  NPD (past)

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1104207927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831010228",
            "telephone_number": "307-877-4715",
            "fax_number": "307-877-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 ANTELOPE STREET",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831013900",
            "telephone_number": "307-877-4715",
            "fax_number": "307-877-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT P. TYRRELL, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-877-4715"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "813",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116184900",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madonna Elizabeth Marie Long
• Ania Mathews, PHARMD
• Novus Wyoming a Professional Corporation
• PG Direct Care LLC
• Ridley's Family Markets Inc (Ridley's pharmacy#1163)
• Karl D Robinson, DDS
• Phillip Robert Rutledge, PA
• Carrie Renee Rydstrom
• Amy Schaffarzick, SLP-CCC
• Robert D. Schaffarzick, O.D.

• General Practice Dentistry in Kemmerer, WY
• Providers in Kemmerer, 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 Jun 17, 2015; 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.