Active NPI
Tyler Mark Veneman, DDS
- Dentist
- Wayland, MI
National Provider Identifier
1649760612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901022591
- Practice address
- 12715 W M 179 Hwy
Wayland, MI 49348-9318 - Phone
- (269) 792-9723
- NPI assigned
- May 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901022591 | MI | Primary |
Addresses
Primary practice location
12715 W M 179 Hwy
Wayland, MI 49348-9318
Mailing address
765 Hampden Ave Apt 136
Saint Paul, MN 55114-1664
Phone (616) 808-7863
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180625003742 | MI | Order and Referring Only - Dentist | 6507111903 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tyler Veneman DDS, PLLC | Current | Accepting new patients |
Locations
12715 W M 179 Hwy
Wayland, MI 49348
Phone (269) 792-9723
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1649760612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 HAMPDEN AVE APT 136",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551141664",
"telephone_number": "616-808-7863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12715 W M 179 HWY",
"city": "WAYLAND",
"state": "MI",
"postal_code": "493489318",
"telephone_number": "269-792-9723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENEMAN",
"first_name": "TYLER",
"middle_name": "MARK",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-15",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901022591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayland, MI
- Vanessa Fitzpatrick LLC (Accessible Care Mobile Wellness)
- Megan Vanhouten
- Matthew Vanover, DC
- Elizabeth Marie Vela, COTA/L
- Joel Patrick Veldhouse, M.D.
- Haley Vos, PA-C
- Wayland Area Emergency Medical Services
- Wayland Area EMS (Wayland Ambulance)
- Wayland Village Drug Inc (Wayland Village Pharmacy)
- Amanda Kay Weersma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.