Tyler Lance Matthew Goodridge, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10832 Issued in NC

Practice address

88 Vilcom Center Dr Ste 190
Chapel Hill, NC 27514-1660

Phone

(919) 968-9806

Fax

(919) 968-7799

NPI assigned

Aug 23, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tyler Goodridge, PLLC Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tyler Goodridge, DDS, PLLC

  • General Practice Dentistry
  • Chapel Hill, NC
  • NPI 1366118036
  NPD Authorized official
• Dennis W Ellis, DDS, PA

  • General Practice Dentistry
  • Chapel Hill, NC
  • NPI 1275740854
  NPD (past)

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124545017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 VILCOM CENTER DR STE 190",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141660",
            "telephone_number": "919-968-9806",
            "fax_number": "919-968-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 VILCOM CENTER DR STE 190",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275141660",
            "telephone_number": "919-968-9806",
            "fax_number": "919-968-7799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 NW Maynard Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138709",
            "country_code": "US",
            "telephone_number": "919-462-3350",
            "fax_number": "919-462-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODRIDGE",
        "first_name": "TYLER",
        "middle_name": "LANCE MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "GOODRIDGE, PLLC",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Samantha Goodman, CRC
• Argelia Veronica Goodner, PHARMD
• William Harold Goodnight III III, MD
• Charles C. Goodno, M.D.
• Jennifer Goodrich, P.H.D.
• Celeste Juanita Kurz Goodwin, RDN, LDN
• Jonathan Stephen Goodwin, PT
• Katharine Mae King Gor, MD
• Jennifer Lynn Goralski, MD
• Kathryn Gordon-Escobar, PA-C

• General Practice Dentistry in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.