Individual provider Active NPI

Richard Travis Tiner, D.D.S., M.S.D.

  • Oral and Maxillofacial Pathology Dentistry
  • Garland, TX
National Provider Identifier
1689765315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
D10859 Issued in TX
Practice address
2910 Broadway Blvd
Sutie 201
Garland, TX 75041-3764
Phone
(972) 271-6528
Fax
(972) 271-6529
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X D10859 TX Primary

Addresses

Primary practice location

2910 Broadway Blvd
Sutie 201
Garland, TX 75041-3764

Mailing address

2910 Broadway Blvd
Sutie 201
Garland, TX 75041-3764
Phone (972) 271-6528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D10859TXMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Garland Oral Surgery & Dental Implant Center, P.a. Past Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689765315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 BROADWAY BLVD",
            "address_2": "SUTIE 201",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750413764",
            "telephone_number": "972-271-6528",
            "fax_number": "972-271-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 BROADWAY BLVD",
            "address_2": "SUTIE 201",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750413764",
            "telephone_number": "972-271-6528",
            "fax_number": "972-271-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINER",
        "first_name": "RICHARD",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TX",
            "license": "D10859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

  • 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.