Tyler Scott Flynn, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DN28261 Issued in FL

Practice address

5 Boulder Rock Dr Ste a
Palm Coast, FL 32137-8538

Phone

(386) 276-9051

Fax

(386) 276-9053

NPI assigned

May 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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.

• Flynn Dental Holdings LLC

  • General Practice Dentistry
  • New Smyrna Beach, FL
  • NPI 1760351761
  NPD Authorized official
• Boulder Rock Dental, LLC

  • General Practice Dentistry
  • Palm Coast, FL
  • NPI 1922515204
  NPD
• Smalltown Dental Tremont

  • Dental Clinic/Center
  • Tremont, IL
  • NPI 1770046088
  NPD (past)

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1205459153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BOULDER ROCK DR STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378538",
            "telephone_number": "386-276-9051",
            "fax_number": "386-276-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BOULDER ROCK DR STE A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378538",
            "telephone_number": "386-276-9051",
            "fax_number": "386-276-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "TYLER",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032582",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN28261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Woman Care, LLC
• Florida Woman Care, LLC
• Elise Matos Flowers
• Fluentpath Rehab
• Flying Nurses International LLC
• Alla Fonseca, M.A. CCC-SLP
• Kimberlie Forbes, PT
• Forefront Chiropractic LLC
• Forever Active Physical Therapy LLC
• Heather Foss

• Dentist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.