Individual provider Active NPI

Tyler Andrew Fix, D.M.D.

  • General Practice Dentistry
  • Bend, OR
National Provider Identifier
1255865374
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10648 Issued in OR
Practice address
80 NE Bend River Mall Ave
Bend, OR 97703-7528
Phone
(541) 647-5555
Fax
(541) 647-5554
NPI assigned
Apr 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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 D10648 OR Primary

Addresses

Primary practice location

80 NE Bend River Mall Ave
Bend, OR 97703-7528

Mailing address

80 NE Bend River Mall Ave
Bend, OR 97703-7528
Phone (541) 647-5555

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
D10648ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eric M Cadwell DDS PLLC CurrentSince Dec 1, 2020 Accepting new patients

Locations

80 NE Bend River Mall Ave
Bend, OR 97703
Phone (541) 647-5555

3081 N Highway 97
Ste 150
Bend, OR 97703
Phone (541) 647-5555

Organizations & group practices 1

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1255865374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 NE BEND RIVER MALL AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037528",
            "telephone_number": "541-647-5555",
            "fax_number": "541-647-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NE BEND RIVER MALL AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037528",
            "telephone_number": "541-647-5555",
            "fax_number": "541-647-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIX",
        "first_name": "TYLER",
        "middle_name": "ANDREW",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.