Active NPI
Charles E Dyer IV, DDS, MS
- Periodontics
- Cypress, TX
National Provider Identifier
1285771352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 21174
- Practice address
- 16316 Spring Cypress
Cypress, TX 77429 - Phone
- (281) 304-9911
- Fax
- (281) 304-9930
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 21174 | TX | Primary |
Addresses
Primary practice location
16316 Spring Cypress
Cypress, TX 77429
Mailing address
16316 Spring Cypress
Cypress, TX 77429
Phone (281) 304-9911
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21174 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles E. Dyer IV, DDS, Ms, PC | Periodontics | Past | Accepting new patients |
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.
-
- Periodontics
- Cypress, TX
- NPI 1407092935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675382400000",
"number": "1285771352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16316 SPRING CYPRESS",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77429",
"telephone_number": "281-304-9911",
"fax_number": "281-304-9930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16316 SPRING CYPRESS",
"city": "CYPRESS",
"state": "TX",
"postal_code": "77429",
"telephone_number": "281-304-9911",
"fax_number": "281-304-9930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "CHARLES",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2023-02-03",
"certification_date": "2023-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "21174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.