Tyson John Gundersen, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN-DEN-LIC-7806 Issued in MT

Practice address

245 E Park St
Butte, MT 59701-1829

Phone

(406) 494-7058

Fax

(406) 782-5812

NPI assigned

Jun 25, 2014

Last updated

Jun 8, 2015By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Silvercreek Family Dentistry PLLC

  dba Silvercreek Family Dentistry

  • General Practice Dentistry
  • Butte, MT
  • NPI 1285008847
  NPD (past) Authorized official

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1821403130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 E PARK ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011829",
            "telephone_number": "406-494-7058",
            "fax_number": "406-782-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 E PARK ST",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011829",
            "telephone_number": "406-494-7058",
            "fax_number": "406-782-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "TYSON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "DEN-DEN-LIC-7806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Paige Gross, LCPC, NCC
• Kristin Elizabeth Grote, D.C.
• Mary Margaret Grupenhoff, LAC
• Shawna L. Guay, MS, LCPC
• Guiding Light Mental Health PC (Guiding Light Mental Health)
• James Raymond Gustafson, O.T.
• Deborah Frisby Hahm, LPN
• Dannielle Hall, PA-C
• Margaret Lee Hall, D.O.
• Wendy Jean Hall, LPN

• Dentist in Butte, MT
• Providers in Butte, MT by specialty
• Dentist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.