Tyler Frey DMD PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TYLER FREY DMD PA

Practice address

1770 San Marco Rd Ste 202
Marco Island, FL 34145-5138

Phone

(239) 394-3200

NPI assigned

Mar 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Tyler Frey, DMDNPI 1073160669

Title

President

Phone

(239) 394-3200

Specialties & licenses 1

Addresses

Other names 1

• Coastal Smiles Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tyler Frey, DMD

  • General Practice Dentistry
  • Marco Island, FL
  • NPI 1073160669
  NPD Authorized official

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583107200000",
    "number": "1265066930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1770 SAN MARCO RD STE 202",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341455138",
            "telephone_number": "239-394-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 SAN MARCO RD STE 202",
            "city": "MARCO ISLAND",
            "state": "FL",
            "postal_code": "341455138",
            "telephone_number": "239-394-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER FREY DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-394-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Smiles Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Duyen Tran
• Erlvinnice Baron Tuanson
• Jenna Urena
• Angela Valenzuela
• Jonathan Van Dyke, DMD
• Anaiya Loree Vaughn
• Adrianna Vega-Alcantar

• Dental Clinic/Center in Marco Island, FL
• Providers in Marco Island, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.