Tyler Carl Prestwich, D.D.S., PH.D., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

T2271 Issued in ND

Practice address

1015 S Broadway Ste 17
Minot, ND 58701-4667

Phone

(701) 852-2646

Fax

(701) 839-1019

NPI assigned

Jan 30, 2013

Last updated

Oct 13, 2015By 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

Credentials

Master of Science, Doctor of Philosophy

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.

• Tyler C Prestwich DDS Ms PLLC

  dba Prestwich Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Minot, ND
  • NPI 1124492327
  Authorized official Same address or phone
• Sommers Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Minot, ND
  • NPI 1942622055
  NPD (past)

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1518205202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 17",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-852-2646",
            "fax_number": "701-839-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S BROADWAY STE 17",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014667",
            "telephone_number": "701-852-2646",
            "fax_number": "701-839-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTWICH",
        "first_name": "TYLER",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PH.D., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-30",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ND",
            "license": "T2271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Minot, ND
• Providers in Minot, ND by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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.