Individual provider Active NPI

Stephen Tyer, DDS

  • Public Health Dentistry
  • Shreveport, LA
National Provider Identifier
1225697196
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
6985 Issued in LA
Practice address
275 Kayla St Ste 100
Shreveport, LA 71105-4257
Phone
(318) 865-0530
NPI assigned
Jun 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 6985 LA Primary

Addresses

Primary practice location

275 Kayla St Ste 100
Shreveport, LA 71105-4257

Mailing address

275 Kayla St Ste 100
Shreveport, LA 71105-4257
Phone (318) 865-0530

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL earnestdds@gmail.com Health Information Exchange (HIE)

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

LicenseStateTypeSpecialty
6985LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1225697196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 KAYLA ST STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054257",
            "telephone_number": "318-865-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 KAYLA ST STE 100",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054257",
            "telephone_number": "318-865-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYER",
        "first_name": "STEPHEN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "LA",
            "license": "6985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "earnestdds@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business E-mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "275 Kayla St Ste 100",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711054257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.