Individual provider Active NPI

Tyler N Williams, DDS

  • Dentist
  • West Jordan, UT
National Provider Identifier
1760702864
Registry record updated Nov 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7692408 Issued in UT
Practice address
2245 Williamsburg Cir
West Jordan, UT 84088-6410
Phone
(801) 513-0148
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7692408 UT Primary

Addresses

Primary practice location

2245 Williamsburg Cir
West Jordan, UT 84088-6410

Mailing address

2245 Williamsburg Cir
West Jordan, UT 84088-6410
Phone (801) 513-3371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001108 UT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5698997302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7692408UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Better Sleep SLC LLC Dentist CurrentSince Apr 10, 2022 Accepting new patients

Locations

6065 S Redwood Rd
Ste 150
Taylorsville, UT 84123
Phone (801) 901-8990

6065 S Redwood Rd
Taylorsville, UT 84123
Phone (801) 503-0035

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289606400000",
    "number": "1760702864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 WILLIAMSBURG CIR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886410",
            "telephone_number": "801-513-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 WILLIAMSBURG CIR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840886410",
            "telephone_number": "801-513-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TYLER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "7692408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.