Tyler J Gagnon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN4629 Issued in ME

Practice address

227 Mount Auburn Ave
Auburn, ME 04210-8521

Phone

(207) 782-3971

NPI assigned

Jun 6, 2018

Sex

Male

Sole proprietor

No

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

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 and National Provider Directory roles.

• Tyler J. Gagnon DMD PA LLC

  • Dental Clinic/Center
  • Auburn, ME
  • NPI 1396408191
  NPD Authorized official

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1548752397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MOUNT AUBURN AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MOUNT AUBURN AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108521",
            "telephone_number": "207-782-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "TYLER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy L Frayer, LCSW
• Jennifer Frazier, DPT
• Paige Frost, OD
• Danielle Claire Gagne, M.S., CCC-SLP
• Mary A Gagnon, LMFT
• Brian L Gallagher, DMD
• Bruce V Gallup, DMD
• Avery Gamache, MS, OTR/L
• Mohamed Gamal-Eldin, MD
• David Gandelman, O.D

• General Practice Dentistry in Auburn, ME
• Providers in Auburn, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.