Individual provider Active NPI

Cynthia Ann Tyson, D.D.S.

  • General Practice Dentistry
  • Cary, NC
National Provider Identifier
1104909498
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7187 Issued in NC
Practice address
218 Ashville Ave
Suite 30
Cary, NC 27511-6118
Phone
(919) 233-1978
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7187 NC Primary

Addresses

Primary practice location

218 Ashville Ave
Suite 30
Cary, NC 27511-6118

Mailing address

218 Ashville Ave
Suite 30
Cary, NC 27511-6118
Phone (919) 233-1978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160114002867 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103129762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104909498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 ASHVILLE AVE",
            "address_2": "SUITE 30",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116118",
            "telephone_number": "919-233-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 ASHVILLE AVE",
            "address_2": "SUITE 30",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275116118",
            "telephone_number": "919-233-1978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.