Active NPI
Adam Paul Tyberg, D.D.S
- General Practice Dentistry
- Sherwood, OR
National Provider Identifier
1740429026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D9258
- Practice address
- 21000 SW Dahlke LN
Sherwood, OR 97140-8386 - Phone
- (503) 925-8600
- NPI assigned
- Feb 11, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D9258 | OR | Primary |
Addresses
Primary practice location
21000 SW Dahlke LN
Sherwood, OR 97140-8386
Mailing address
21000 SW Dahlke LN
Sherwood, OR 97140-8386
Phone (503) 925-8600
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 |
|---|---|---|---|
| D9258 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281571200000",
"number": "1740429026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21000 SW DAHLKE LN",
"city": "SHERWOOD",
"state": "OR",
"postal_code": "971408386",
"telephone_number": "503-925-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21000 SW DAHLKE LN",
"city": "SHERWOOD",
"state": "OR",
"postal_code": "971408386",
"telephone_number": "503-925-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYBERG",
"first_name": "ADAM",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-02-11",
"last_updated": "2010-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D9258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sherwood, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.