Tyson Max Jolley, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9783 Issued in AZ

Practice address

4803 E Ray Rd
P002C
Phoenix, AZ 85044-6496

Phone

(480) 755-4455

NPI assigned

Sep 22, 2017

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

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506038400000",
    "number": "1568971406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 E RAY RD # P002C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446496",
            "telephone_number": "480-755-4455",
            "fax_number": "480-893-7535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 E RAY RD",
            "address_2": "P002C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446496",
            "telephone_number": "480-755-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "TYSON",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-22",
        "last_updated": "2017-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "9783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joint Regenerative LLC
• Mary Minu Joji, MSN,FNP-C
• Breanne Jojola, BCBA
• Deepthy Jolal, NP
• Sandra Jolley, LMT
• Melissa Jolliffe
• Heather Jolly, M.A., NCSP
• Rebecca Bryant Jolly
• Elizabeth Ann Joly, LISAC
• Sandra Joly

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; 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.