Active NPI
Warren Blake Lockett Pyle, DMD
- Dentist
- Glendale, AZ
National Provider Identifier
1730705179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN.00204794
- Practice address
- 9455 W Glendale Ave
Glendale, AZ 85305-2572 - Phone
- (480) 485-7436
- NPI assigned
- Jun 22, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN.00204794 | CO | Primary |
| General Practice Dentistry | 1223G0001X | T-DEN.00000046 | CO |
Addresses
Primary practice location
9455 W Glendale Ave
Glendale, AZ 85305-2572
Mailing address
302 W Montezuma Ave
Cortez, CO 81321-2750
Phone (970) 459-1314
Other practice location 1
302 W Montezuma Ave
Cortez, CO 81321-2750
Phone (970) 459-1314
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
| License | State | Type | Specialty |
|---|---|---|---|
| DEN.00204794 | CO | MD | Dentist |
| T-DEN.00000046 | CO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tavamuwisi Dental Group PLLC | Current | Accepting new patients |
Locations
302 W Montezuma Ave
Cortez, CO 81321
Phone (970) 459-1314
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": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712102400000",
"number": "1730705179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 W MONTEZUMA AVE",
"city": "CORTEZ",
"state": "CO",
"postal_code": "813212750",
"telephone_number": "970-459-1314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9455 W GLENDALE AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853052572",
"telephone_number": "480-485-7436"
}
],
"practiceLocations": [
{
"address_1": "302 W Montezuma Ave",
"address_purpose": "LOCATION",
"city": "Cortez",
"state": "CO",
"postal_code": "813212750",
"country_code": "US",
"telephone_number": "970-459-1314",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PYLE",
"first_name": "WARREN",
"middle_name": "BLAKE LOCKETT",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-22",
"last_updated": "2024-04-03",
"certification_date": "2022-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN.00204794",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "T-DEN.00000046",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.