Tyson Dental Associates PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

3680 Issued in AR

Legal business name

TYSON DENTAL ASSOCIATES PLLC

Doing business as

Jonesboro Pediatric Dental Group

Practice address

620 Southwest Dr
Jonesboro, AR 72401-5859

Phone

(870) 336-9700

NPI assigned

Jun 2, 2011

Last updated

Aug 9, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Summer Barker Tyson, DDSNPI 1720242167

Title

Owner

Phone

(870) 336-9700

Specialties & licenses 1

Addresses

Other names 1

• Jonesboro Pediatric Dental Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Summer Barker Tyson, D.D.S

  • Pediatric Dentistry
  • Jonesboro, AR
  • NPI 1720242167
  NPD (past) Authorized official

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

{
    "created_epoch": "1306972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1538453006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015859",
            "telephone_number": "870-336-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SOUTHWEST DR",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015859",
            "telephone_number": "870-336-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYSON DENTAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-02",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_middle_name": "BARKER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-336-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jonesboro Pediatric Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margarett Angelina Tyler, APRN
• Shay Renee Tyler, APRN
• Victoria Tyner, MHPP
• Tyrer Dentistry, PA (Tyrer Dental Care)
• Dean A. Tyrer, D.D.S
• Summer Barker Tyson, D.D.S
• Benjamin B Ulibarri, PMHNP
• Deborah Ulibarri, LPN
• Maryjoanne Chinyem Umeora, M.D
• Ahmed Muaaz Umer, MBBS

• Pediatric Dentistry in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Pediatric Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.