Active NPI
Tyler Tomkinson
- Dental Anesthesiology
- Phoenix, AZ
National Provider Identifier
1841604659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- D10072
- Practice address
- 13601 N Canterbury Dr
Phoenix, AZ 85023 - Phone
- (480) 221-5080
- NPI assigned
- Jun 19, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dental Anesthesiology | 1223D0004X | D10072 | AZ | Primary |
Addresses
Primary practice location
13601 N Canterbury Dr
Phoenix, AZ 85023
Mailing address
1776 E Caborca Dr
Casa Grande, AZ 85122-6381
Phone (480) 221-5080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404557 | Medicaid | AZ |
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 |
|---|---|---|---|
| D10072 | AZ | MD | Dentist Anesthesiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Anesthesia Specialists PLLC | Dental Anesthesiology | Current | Accepting new patients |
| Comfort Care Anesthesia, LLC | Dental Anesthesiology | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1881185791
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535673600000",
"number": "1841604659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 E CABORCA DR",
"city": "CASA GRANDE",
"state": "AZ",
"postal_code": "851226381",
"telephone_number": "480-221-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13601 N CANTERBURY DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85023",
"telephone_number": "480-221-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMKINSON",
"first_name": "TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-19",
"last_updated": "2018-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "AZ",
"license": "D10072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "404557",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.