Individual provider Active NPI

Tyler Birk, DDS

  • Dentist
  • Round Rock, TX
National Provider Identifier
1144954793
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39381 Issued in TX
Practice address
5290 N a W Grimes Blvd Unit 400
Round Rock, TX 78665-2728
Phone
(737) 201-3481
NPI assigned
Jul 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39381 TX Primary

Addresses

Primary practice location

5290 N a W Grimes Blvd Unit 400
Round Rock, TX 78665-2728

Mailing address

1609 Dapplegrey LN
Austin, TX 78727-4571

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

LicenseStateTypeSpecialty
39381TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1144954793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 DAPPLEGREY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787274571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 N A W GRIMES BLVD UNIT 400",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652728",
            "telephone_number": "737-201-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRK",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "39381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.