NPIMap

Organization Active NPI

University Dental Assoc., PC

  • General Practice Dentistry
  • Rochester, MI
National Provider Identifier
1689782849
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
UNIVERSITY DENTAL ASSOC., PC
Practice address
435 Pine St
Rochester, MI 48307-1933
Phone
(248) 652-9116
Fax
(248) 652-3136
NPI assigned
Aug 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Brian Gibbs Tyler, DDSNPI 1821140013
Title
Dentist
Phone
(248) 652-9116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

435 Pine St
Rochester, MI 48307-1933

Mailing address

435 Pine St
Rochester, MI 48307-1933
Phone (248) 652-9116

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689782849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 PINE ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071933",
            "telephone_number": "248-652-9116",
            "fax_number": "248-652-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PINE ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071933",
            "telephone_number": "248-652-9116",
            "fax_number": "248-652-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DENTAL ASSOC., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "GIBBS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "248-652-9116",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.