Active NPI
Tyler J Canales, DDS
- General Practice Dentistry
- Bartlett, TN
National Provider Identifier
1104371160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11156
- Practice address
- 3105 Kirby Whitten Rd
Bartlett, TN 38134-2822 - Phone
- (901) 388-9883
- NPI assigned
- Aug 19, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11156 | TN | Primary |
| General Practice Dentistry | 1223G0001X | DB-2026-0315 | NM |
Addresses
Primary practice location
3105 Kirby Whitten Rd
Bartlett, TN 38134-2822
Mailing address
3105 Kirby Whitten Rd
Bartlett, TN 38134-2822
Phone (901) 388-9883
Other practice location 1
2116 Vista Oeste NW Ste 202
Albuquerque, NM 87120-4341
Phone (505) 487-8690
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170307001613 | UT | Order and Referring Only - Other (Non-Physician) | 8628352887 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Jordan Modern Dentistry , LLP | General Practice | Past | Accepting new patients |
| Bartlett Dental Associates PLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Bartlett, TN
- NPI 1336114230
-
- General Practice Dentistry
- West Jordan, UT
- NPI 1508134412
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1104371160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 KIRBY WHITTEN RD",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381342822",
"telephone_number": "901-388-9883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 KIRBY WHITTEN RD",
"city": "BARTLETT",
"state": "TN",
"postal_code": "381342822",
"telephone_number": "901-388-9883"
}
],
"practiceLocations": [
{
"address_1": "2116 Vista Oeste NW Ste 202",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871204341",
"country_code": "US",
"telephone_number": "505-487-8690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANALES",
"first_name": "TYLER",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-19",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TN",
"license": "11156",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NM",
"license": "DB-2026-0315",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bartlett, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.