Tyler Mills Aten, D.M.D.
Individual provider Active NPI Dentist · South Burlington, VT
NPI 1437564580 · NPPES record last updated Apr 24, 2018
Key facts
- NPI
- 1437564580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 016.0112532 (VT)
- Practice address
- 118 Tilley Dr
Suite 101
South Burlington, VT 05403-4450 - Phone
- (802) 863-3950
- NPI assigned
- Jun 27, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016.0112532 | VT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Station Dentistry PLC | Current | Accepting new patients | |
| St. Albans Dental PLC | Current | Accepting new patients | |
| Theodorou Dental Partners LLC | Dentist | Past | Accepting new patients |
| Green Mountain Dental, PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 016.0112532 | VT | Yes |
Addresses
Primary practice location
118 Tilley Dr
Suite 101
South Burlington, VT 05403-4450
Mailing address
118 Tilley Dr
Suite 101
South Burlington, VT 05403-4450
Phone (802) 863-3950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004011136 | Medicaid | CT |
Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.