Tyler Steven Wallingford, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS-09431 Issued in IA

Practice address

402 Poplar St
Atlantic, IA 50022-1250

Phone

(712) 243-3275

Fax

(712) 243-8024

NPI assigned

Jun 12, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timothy J Kreifels DDS PC

  • Dental Clinic/Center
  • Atlantic, IA
  • NPI 1275708117
  NPD (past)

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396274429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 POPLAR ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221250",
            "telephone_number": "712-243-3275",
            "fax_number": "712-243-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 POPLAR ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221250",
            "telephone_number": "712-243-3275",
            "fax_number": "712-243-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLINGFORD",
        "first_name": "TYLER",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-09431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nina Utterback, CADC
• Angela Van Horn, CADC
• Adam Joel Verhoef, MD
• Daniel P Vogel, DPT
• Wal-Mart Stores, Inc. (Vision Center 30-3394)
• Walmart Inc. (Walmart Pharmacy 10-3394)
• Nichole Marie Waterman
• William Waters, CADC
• Weight Loss & Wellness LLC
• Angela B Weppler, M.D.

• Dentist in Atlantic, IA
• Providers in Atlantic, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.