Tyler Mark Whiting, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

00204685 Issued in CO

Practice address

1903 Wilmington Dr Unit 101
Fort Collins, CO 80528-6100

Phone

(970) 568-5255

NPI assigned

Jun 18, 2015

Sex

Male

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1124400890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "486 WEST FIRST AVE",
            "city": "GLENNS FERRY",
            "state": "ID",
            "postal_code": "83623",
            "telephone_number": "208-366-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 WILMINGTON DR UNIT 101",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805286100",
            "telephone_number": "970-568-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "TYLER",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4670",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "00204685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@endorockies.com",
            "affiliation": "Y",
            "affiliationName": "Endodontics of the Rockies, PLLC",
            "address_1": "1903 Wilmington Dr Unit 101",
            "city": "Fort Collins",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805286100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer White, LCSW
• Rachel White
• Rachel Condon White
• Steven Whitehead
• Chelsea Corrine Whitely
• Kathleen P Whitley, M.D.
• Douglas W Whitman, MD
• Elizabeth Ashley Whitman
• Brianna Heather Whitmore
• Whitney Helton Nutrition and Wellness, LLC

• Endodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Endodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.