Individual provider Active NPI

Tyler Lamoine Saunders, DMD

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1164737367
Registry record updated Aug 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8048 Issued in AZ
Practice address
655 S Dobson Rd
BLDG B, Suite 211
Chandler, AZ 85224-5667
Phone
(480) 917-8400
NPI assigned
Aug 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8048 AZ Primary

Addresses

Primary practice location

655 S Dobson Rd
BLDG B, Suite 211
Chandler, AZ 85224-5667

Mailing address

3080 E Kingbird Dr
Gilbert, AZ 85297-8162
Phone (480) 748-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150425000392 AZ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305165374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8048AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Adrian Huang D.M.D., P.L.L.C. General Practice Past Accepting new patients
Chandler Dental PLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472256000000",
    "number": "1164737367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 E KINGBIRD DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852978162",
            "telephone_number": "480-748-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 S DOBSON RD",
            "address_2": "BLDG B, SUITE 211",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245667",
            "telephone_number": "480-917-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "TYLER",
        "middle_name": "LAMOINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2016-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.