Active NPI
Thomas L Tyree DDS Inc
- General Practice Dentistry
- Kenova, WV
National Provider Identifier
1376612887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2421
- Legal business name
- THOMAS L TYREE DDS INC
- Practice address
- 1702 Oak St
Kenova, WV 25530-1120 - Phone
- (304) 453-6765
- Fax
- (304) 453-1695
- NPI assigned
- Nov 7, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas L Tyree, DDS
- Title
- President
- Phone
- (304) 453-6765
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2421 | WV | Primary |
Addresses
Primary practice location
1702 Oak St
Kenova, WV 25530-1120
Mailing address
1702 Oak St
Kenova, WV 25530-1120
Phone (304) 453-6765
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0136238000 | Medicaid | WV | |
| 0135603 | Other | WV | DENTAL PROVIDER |
National Provider Directory
National Provider DirectoryLocations
1702 Oak St
Kenova, WV 25530
Phone (304) 453-6765
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Kenova, WV
- NPI 1033288691
-
- General Practice Dentistry
- Kenova, WV
- NPI 1568522100
-
- Dental Hygienist
- Kenova, WV
- NPI 1396814869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1376612887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 OAK ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301120",
"telephone_number": "304-453-6765",
"fax_number": "304-453-1695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 OAK ST",
"city": "KENOVA",
"state": "WV",
"postal_code": "255301120",
"telephone_number": "304-453-6765",
"fax_number": "304-453-1695"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THOMAS L TYREE DDS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TYREE",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "304-453-6765",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "2421",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0136238000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL PROVIDER",
"identifier": "0135603",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenova, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.