Individual provider Active NPI

Tyler J Canales, DDS

  • General Practice Dentistry
  • Bartlett, TN
National Provider Identifier
1104371160
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11156 Issued in TN
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

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170307001613 UT Order and Referring Only - Other (Non-Physician) 8628352887

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.