Active NPI
Eric Royall Tyler, D.D.S.
- General Practice Dentistry
- Novato, CA
National Provider Identifier
1255570958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 51665
- Practice address
- 190 San Marin Dr
Suite a
Novato, CA 94945-1218 - Phone
- (415) 897-6877
- Fax
- (415) 897-5437
- NPI assigned
- Feb 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 51665 | CA | Primary |
Addresses
Primary practice location
190 San Marin Dr
Suite a
Novato, CA 94945-1218
Mailing address
190 San Marin Dr
Suite a
Novato, CA 94945-1218
Phone (415) 897-6877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 6, 2016 through Jan 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235001600000",
"number": "1255570958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 SAN MARIN DR",
"address_2": "SUITE A",
"city": "NOVATO",
"state": "CA",
"postal_code": "949451218",
"telephone_number": "415-897-6877",
"fax_number": "415-897-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 SAN MARIN DR",
"address_2": "SUITE A",
"city": "NOVATO",
"state": "CA",
"postal_code": "949451218",
"telephone_number": "415-897-6877",
"fax_number": "415-897-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLER",
"first_name": "ERIC",
"middle_name": "ROYALL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-19",
"last_updated": "2009-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "51665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.