Active NPI
Tyler Moyle, DDS
- Dentist
- Modesto, CA
National Provider Identifier
1477228468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 106832
- Practice address
- 2045 W Briggsmore Ave
Modesto, CA 95350-3767 - Phone
- (515) 975-7815
- NPI assigned
- Aug 11, 2021
- 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 | 106832 | CA | Primary |
Addresses
Primary practice location
2045 W Briggsmore Ave
Modesto, CA 95350-3767
Mailing address
7013 Dakota Dr
West Des Moines, IA 50266-2410
Phone (515) 975-7815
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106832 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1477228468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7013 DAKOTA DR",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502662410",
"telephone_number": "515-975-7815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2045 W BRIGGSMORE AVE",
"city": "MODESTO",
"state": "CA",
"postal_code": "953503767",
"telephone_number": "515-975-7815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYLE",
"first_name": "TYLER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "106832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.