Tyson Heath Roulston, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6407 Issued in OK

Practice address

1226 W Broadway St
Drumright, OK 74030-5826

Phone

(918) 352-3312

NPI assigned

Jun 27, 2012

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1699039339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19434 W 105TH ST S",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740668055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 W BROADWAY ST",
            "city": "DRUMRIGHT",
            "state": "OK",
            "postal_code": "740305826",
            "telephone_number": "918-352-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULSTON",
        "first_name": "TYSON",
        "middle_name": "HEATH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "6407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginny Marie Polm, APRN
• Paige S. Powell, P.T.A.
• Helga Renee Price, PA C
• Andrea J. Retherford, PT
• Robert H Melton, DDS, PC (Drumright Dental Center)
• Hannah Marie Scroggins
• Erin M Sexson, DDS
• Christopher Michael Smith
• Donna H. Sylvester, P.T.
• Team Clinics Ah LLC

• General Practice Dentistry in Drumright, OK
• Providers in Drumright, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.