Tyler Nelson, DDS, Corp.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

TYLER NELSON, DDS, CORP.

Practice address

950 Boardwalk Ste 100
San Marcos, CA 92078-2600

Phone

(760) 644-5494

NPI assigned

Aug 13, 2020

Last updated

Jul 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Nelson, DDSNPI 1790093599

Title

Owner

Phone

(719) 722-0540

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tyler E Nelson, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • San Marcos, CA
  • NPI 1790093599
  NPD Authorized official

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1134730914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 BOARDWALK STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782600",
            "telephone_number": "760-644-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 BOARDWALK STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782600",
            "telephone_number": "760-644-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER NELSON, DDS, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-722-0540",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.