Individual provider Active NPI

Tyler John Dandurand-Reynolds, HAD

  • Hearing Instrument Specialist
  • Chula Vista, CA
National Provider Identifier
1336887165
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA8765 Issued in CA
Practice address
310 3Rd Ave Ste B21
Chula Vista, CA 91910-3953
Phone
(619) 426-0841
Fax
(619) 426-9197
NPI assigned
May 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA8765 CA Primary

Addresses

Primary practice location

310 3Rd Ave Ste B21
Chula Vista, CA 91910-3953

Mailing address

13820 Donnybrook LN
Moorpark, CA 93021-2827
Phone (310) 989-3092

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
HA8765CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
American Hearing Aid Center of the South Bay, Inc CurrentSince May 29, 2022 Accepting new patients
Serendipity Hearing Inc Hearing Instrument Specialist CurrentSince Oct 29, 2018 Accepting new patients

Locations

310 Third Ave
Ste B21
Chula Vista, CA 91910
Phone (619) 426-0841

801 Orange Ave
Ste 205
Coronado, CA 92118
Phone (619) 437-8154

1767 E Main St
El Cajon, CA 92021
Phone (619) 440-6516

5555 Garden Grove Blvd
Ste 200
Westminster, CA 92683
Phone (714) 804-5725

Organizations & group practices 2

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1336887165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13820 DONNYBROOK LN",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212827",
            "telephone_number": "310-989-3092",
            "fax_number": "805-530-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 3RD AVE STE B21",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919103953",
            "telephone_number": "619-426-0841",
            "fax_number": "619-426-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDURAND-REYNOLDS",
        "first_name": "TYLER",
        "middle_name": "JOHN",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; 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.