Active NPI
Tyra Neal, DMD
- Dentist
- Provo, UT
National Provider Identifier
1144602970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6277669
- Practice address
- 1450 W 820 N
Provo, UT 84601-1305 - Phone
- (801) 818-8917
- NPI assigned
- Jun 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6277669 | UT | Primary |
Addresses
Primary practice location
1450 W 820 N
Provo, UT 84601-1305
Mailing address
2158 E Bald Eagle CT
Draper, UT 84020-5714
Phone (435) 757-9717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6277669 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435536000000",
"number": "1144602970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2158 E BALD EAGLE CT",
"city": "DRAPER",
"state": "UT",
"postal_code": "840205714",
"telephone_number": "435-757-9717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 W 820 N",
"city": "PROVO",
"state": "UT",
"postal_code": "846011305",
"telephone_number": "801-818-8917"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEAL",
"first_name": "TYRA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-29",
"last_updated": "2015-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "6277669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.