Active NPI
Dustin Tyler Nygard, DMD
- Dentist
- Fort Irwin, CA
National Provider Identifier
1306327796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 34564
- Practice address
- BLDG, 390 N Loop Rd
Fort Irwin, CA 92310 - Phone
- (760) 380-3166
- NPI assigned
- Aug 24, 2018
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 34564 | TX | Primary |
Addresses
Primary practice location
BLDG, 390 N Loop Rd
Fort Irwin, CA 92310
Mailing address
171 Inner Loop Rd
Fort Irwin, CA 92310
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
| License | State | Type | Specialty |
|---|---|---|---|
| 34564 | TX | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1306327796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "171 INNER LOOP RD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG, 390 N LOOP RD",
"city": "FORT IRWIN",
"state": "CA",
"postal_code": "92310",
"telephone_number": "760-380-3166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYGARD",
"first_name": "DUSTIN",
"middle_name": "TYLER",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-24",
"last_updated": "2024-08-13",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "34564",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Irwin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.