Tye Padilla, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-5288 Issued in ID

Practice address

223 W Ironwood Dr
Coeur D Alene, ID 83814-2651

Phone

(208) 277-9321

NPI assigned

Jun 11, 2021

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623456000000",
    "number": "1437727005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15720 E 4TH AVE APT C108",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W IRONWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142651",
            "telephone_number": "208-277-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "TYE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-12",
        "certification_date": "2021-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-5288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredrick Mark Owsley, M.D.
• Pacific Capital and Consulting, LLC
• Pacifica L 44 LLC
• Pacifica Sherman LLC
• Jeanna Padilla, CPNP-PC
• Shadell Padmore
• Pain Management of North Idaho, PLLC
• Erin Anne Paisley
• Paladin Services, LLC
• Angela Marie Palmer, CADC

• General Practice Dentistry in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; 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.