Ty Dental Meadowbrook PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TY DENTAL MEADOWBROOK PLLC

Practice address

6302 Meadowbrook Dr
Fort Worth, TX 76112-5162

Phone

(956) 507-7253

NPI assigned

Dec 22, 2025

Organization subpart

No

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

Authorized official

Name

Tien Phan

Title

Owner

Phone

(408) 835-3726

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1346105392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8150 SPRINGWOOD DR STE 150B",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635810",
            "telephone_number": "956-507-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 MEADOWBROOK DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761125162",
            "telephone_number": "956-507-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TY DENTAL MEADOWBROOK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "TIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-835-3726"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda M Tydlaska, CPNP
• Janice Michelle Tyler, M.D.
• Jerica Lee Tyler
• Lawanda Tyler
• Tami Deshele Tyler, RN

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; 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.