Tyler Michael Aholt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2012015662 Issued in MO

Practice address

4620 Hampton Ave
Saint Louis, MO 63109-2714

Phone

(314) 752-7468

Fax

(314) 752-5168

NPI assigned

May 24, 2012

Last updated

Apr 17, 2023By 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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 M Aholt DDS LLC

  • Dentist
  • Saint Louis, MO
  • NPI 1952775793
  NPD (past) Authorized official
• Premium Vision Solutions, LLC

  dba Fontana Eyecare Associates

  • Optometrist
  • Saint Louis, MO
  • NPI 1174944011
  NPD (past)

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1548520570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092714",
            "telephone_number": "314-752-7468",
            "fax_number": "314-752-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 HAMPTON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092714",
            "telephone_number": "314-752-7468",
            "fax_number": "314-752-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHOLT",
        "first_name": "TYLER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2012015662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Ahmed, MD, MPH
• Summayya Ahmed
• Zarir Ahmed
• Ziauddin Ahmed, MD
• Nadia Jemal Ahmedin
• Anna M Ahrens, ANP
• Christopher Michael Ahrens, D.O.
• Serena A Ahrens, MS CCC-SLP
• Ahs Missouri Medical Group LLC
• Salman Ahsan, MD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.