Tyler G Shaw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2395 Issued in ND

Practice address

515 20TH Ave SE Ste 8
Minot, ND 58701-6661

Phone

(701) 852-4755

NPI assigned

Jun 11, 2008

Sex

Male

Sole proprietor

Yes

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)

Enrolled

State licenses

Practice roles

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.

• Dakota Dental Health Center

  • General Practice Dentistry
  • Minot, ND
  • NPI 1619185824
  NPD (past)
• Dakota Dental Health Center PLLC

  • General Practice Dentistry
  • Minot, ND
  • NPI 1639414451
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1184884371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 20TH AVE SE STE 8",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587016661",
            "telephone_number": "701-852-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "TYLER",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rayanne F Shannon, DDS
• Angela Joy Shaw
• Avi Shaw, DO
• Lauren Shaw
• Mary Elizabeth Shaw, HIS
• Misty Shearer, LSW
• Jane Shekleton, OT
• Martha G Shelver, NP
• Jaime M Sheperd, MD
• Cassie Anne Sheppard, CCC-SLP

• General Practice Dentistry in Minot, ND
• Providers in Minot, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.