Tyler D. Clark DMD, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D9605 Issued in OR

Legal business name

TYLER D. CLARK DMD, PC

Practice address

27 W 17TH Ave
Eugene, OR 97401-4012

Phone

(541) 344-0413

Fax

(541) 344-3657

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

Tyler D Clark, DMDNPI 1447538954

Title

Owner

Phone

(541) 344-0413

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Duane Clark, DMD

  • Dentist
  • Eugene, OR
  • NPI 1447538954
  NPD (past) Authorized official
• Mark A. O'Hara, D.D.S

  • General Practice Dentistry
  • Eugene, OR
  • NPI 1437223021
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1144709635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014012",
            "telephone_number": "541-344-0413",
            "fax_number": "541-344-3657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014012",
            "telephone_number": "541-344-0413",
            "fax_number": "541-344-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER D. CLARK DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-344-0413",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Tustin, D.D.S.
• Abby Tuttle Shamblin, M.ED.
• Keenan Aleksei Tvedt, LMT
• Two Rivers Clinic
• Patricia Diane Twombly, LPN
• Tyler Whiting Pediatric Dentistry PC (Every Kid Pediatric Dentistry)
• Mary Lawrence Tyler, LCSW
• Tyler N Tylinski, P.T.
• Jaclyn Lee Tyrrell
• Samantha Uehlin

• Dentist in Eugene, OR
• Providers in Eugene, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.