Kenneth K Tyer Sr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6762 Issued in TX

Practice address

2121 Timberlane St Ste a
Conroe, TX 77301-1176

Phone

(936) 756-1443

Fax

(936) 756-1406

NPI assigned

Aug 2, 2006

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

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609883396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 TIMBERLANE ST STE A",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011106",
            "telephone_number": "936-756-1443",
            "fax_number": "936-756-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 TIMBERLANE ST STE A",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773011176",
            "telephone_number": "936-756-1443",
            "fax_number": "936-756-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYER",
        "first_name": "KENNETH",
        "middle_name": "K",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "6762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Turner
• TV Oliver Vision PA
• Two Roads Recovery PLLC
• Two Tim One LLC
• TX Southern Dental PPO PC
• Miles Tyler
• U S Anesthesia Partners of Texas, PA
• Moses Anos Ubaechu
• John N Ugwu, CEO
• Chisom Faith Ugwunze, RD, LD

• General Practice Dentistry in Conroe, TX
• Providers in Conroe, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.