Active NPI
Tyler Ray Strom, DMD
- Dentist
- Leesburg, GA
National Provider Identifier
1154057958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN122820
- Practice address
- 138 Oakland Pkwy
Leesburg, GA 31763-7200 - Phone
- (229) 432-2213
- NPI assigned
- Jul 26, 2022
- Last updated
- Jun 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | DN122820 | GA | Primary |
Addresses
Primary practice location
138 Oakland Pkwy
Leesburg, GA 31763-7200
Mailing address
138 Oakland Pkwy
Leesburg, GA 31763-7200
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 |
|---|---|---|---|
| DN122820 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687219200000",
"number": "1154057958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 OAKLAND PKWY",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317637200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 OAKLAND PKWY",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317637200",
"telephone_number": "229-432-2213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STROM",
"first_name": "TYLER",
"middle_name": "RAY",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-07-26",
"last_updated": "2023-06-20",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "GA",
"license": "DN122820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, GA
- Stat Lab Solutions
- Samara Sterling, PHD, RD, DIPACLM
- Lauren Lane Stoklosa, SPEECH PATHOLOGIST
- Steven Joseph Stoklosa, OT R
- Marcia Wynn Stoler, RDH
- Sullivan Drug Company (The Pharmhouse)
- Shana Sullivan, PHARMD
- Sumter Pediatrics LLC (Sumter Pediatrics)
- Crystal Lea Swain, COTA/L
- Sassy Lashawn Sylvester, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.