Tyler Meadows Davis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001705-15 Issued in WI

Practice address

1201 Oak St Ste D
West Bend, WI 53095-3800

Phone

(262) 310-1860

Fax

(262) 310-1861

NPI assigned

Oct 31, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Davis Family Dental, SC

  • General Practice Dentistry
  • West Bend, WI
  • NPI 1578322897
  NPD Authorized official
• Slinger Family Dentistry LLC

  • General Practice Dentistry
  • Slinger, WI
  • NPI 1679359319
  NPD (past)

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1154833044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N161W20685 KAMI LN",
            "city": "JACKSON",
            "state": "WI",
            "postal_code": "530378937",
            "telephone_number": "262-622-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 OAK ST STE D",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953800",
            "telephone_number": "262-310-1860",
            "fax_number": "262-310-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TYLER",
        "middle_name": "MEADOWS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-31",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001705-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Jo Dauss, MS, ATC, LAT
• Debra L Dautermann, PT
• Davis Family Dental, SC
• Denise Elizabeth Davis, MD
• Mary Davis, RN
• Nora De Lise, D.P.T.
• Janice Marie De Smidt, MA CCC-SLP
• Jennifer Deering, APNP
• Teresa Delcore
• Rhyann Deline, DC

• General Practice Dentistry in West Bend, WI
• Providers in West Bend, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.