Tyson Perrero, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9054 Issued in KY

Practice address

2105 Weber Ave
Louisville, KY 40205-2110

Phone

(502) 473-2011

Fax

(502) 473-2013

NPI assigned

Jun 16, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Mortenson Family Dental Center-Highlands PLLC

  • Dental Clinic/Center
  • Louisville, KY
  • NPI 1497905244
  NPD (past)
• Provo Dental Care LLC

  • Dental Clinic/Center
  • Provo, UT
  • NPI 1497168975
  NPD (past)
• Stonehaven Dental - Draper, LLC

  • Dental Clinic/Center
  • Draper, UT
  • NPI 1326459348
  NPD (past)

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1861629941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 WEBER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052110",
            "telephone_number": "502-473-2011",
            "fax_number": "502-473-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 WEBER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052110",
            "telephone_number": "502-473-2011",
            "fax_number": "502-473-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRERO",
        "first_name": "TYSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9054",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100178410",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janee Nicole Perks Banks
• William T Perks IV, D.C.
• Katharina Rose Perlin, MD
• Austin Stone Permann, DO
• John Perpich
• Gregory Perri, PSY.D.
• Isabelle Makayla Perricone, MA
• Melissa Lee Perrotta, M.D.
• Aleshia M Perry
• Angela Perry

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.