Carl Joseph Tyree, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12007389A Issued in IN

Practice address

2100 45TH St
Highland, IN 46322-3742

Phone

(219) 924-4411

Fax

(219) 924-2314

NPI assigned

Oct 10, 2006

Last updated

Sep 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: jtyree106599@direct.franciscanalliance.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Dental Associates of Indiana, Inc

  • Pediatric Dentistry
  • Highland, IN
  • NPI 1679661565
  Authorized official Same address or phone

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1780772665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223742",
            "telephone_number": "219-924-4411",
            "fax_number": "219-924-2314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 45TH ST",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463223742",
            "telephone_number": "219-924-4411",
            "fax_number": "219-924-2314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Wall St",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463832564",
            "country_code": "US",
            "telephone_number": "219-462-6337",
            "fax_number": "219-462-8247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TYREE",
        "first_name": "CARL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12007389A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208100B",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100208100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Tsiakopoulos, RPH
• George V. Tsoutsouris, D.P.M.
• Mary Tujetsch, D.D.S.
• Adesola Modupe Turner
• Vanessa Turner, APRN
• Uro Surgery Associates LLC
• V-Care Home Health Services LLC
• Steve James Vargo, O.D.
• Shridhar Ventrapragada, M.D.
• Robert Vercel, RPH

• Pediatric Dentistry in Highland, IN
• Providers in Highland, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.