Organization Active NPI

Thomas J Lyle DDS PC

  • Dentist
  • Des Moines, IA
National Provider Identifier
1376700260
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
06797 Issued in IA
Legal business name
THOMAS J LYLE DDS PC
Practice address
2707 Easton Blvd
Des Moines, IA 50317-6123
Phone
(515) 265-0339
Fax
(515) 265-0339
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Dr. Thomas James Lyle, DDS
Title
President
Phone
(515) 265-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 06797 IA Primary

Addresses

Primary practice location

2707 Easton Blvd
Des Moines, IA 50317-6123

Mailing address

2707 Easton Blvd
Des Moines, IA 50317-6123
Phone (515) 265-0339

Other identifiers 1

IdentifierTypeStateIssuer
0195958MedicaidIA

National Provider Directory

National Provider Directory

Locations

2707 Easton Blvd
Des Moines, IA 50317
Phone (515) 265-0339

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1376700260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 EASTON BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176123",
            "telephone_number": "515-265-0339",
            "fax_number": "515-265-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 EASTON BLVD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503176123",
            "telephone_number": "515-265-0339",
            "fax_number": "515-265-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J LYLE DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "LYLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-265-0339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IA",
            "license": "06797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195958",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.