Active NPI
Tyler L Scott, DMD
- Dentist
- Medford, OR
National Provider Identifier
1447515309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D9748
- Practice address
- 1113 Progress Dr
Medford, OR 97504-5201 - Phone
- (541) 512-3182
- Fax
- (541) 512-1026
- NPI assigned
- Jul 6, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9748 | OR | Primary |
Addresses
Primary practice location
1113 Progress Dr
Medford, OR 97504-5201
Mailing address
931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9748 | OR | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica del Valle Family Health Care Center Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba East Medford Dental Clinic-La Clinica
- Federally Qualified Health Center (FQHC)
- Medford, OR
- NPI 1891061784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584576000000",
"number": "1447515309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127",
"telephone_number": "541-690-3555",
"fax_number": "541-842-2212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1113 PROGRESS DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975045201",
"telephone_number": "541-512-3182",
"fax_number": "541-512-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCOTT",
"first_name": "TYLER",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-06",
"last_updated": "2020-03-19",
"certification_date": "2020-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "OR",
"license": "D9748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.