Tyler William Kisling, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64864 Issued in CA

Practice address

10930 Crabapple Rd
Suite 106
Roswell, GA 30075-5813

Phone

(678) 352-1090

NPI assigned

Jul 29, 2015

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

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1891170015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10930 CRABAPPLE RD",
            "address_2": "SUITE 106",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755813",
            "telephone_number": "678-352-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10930 CRABAPPLE RD",
            "address_2": "SUITE 106",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755813",
            "telephone_number": "678-352-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLING",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64864",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Franklin Kirkpatrick, LPC
• Josephine Kim Kirkup, MA, LPC
• Joel I Kirson, M.D.
• Mark Kishel, M.D.
• Eric Kiskaddon
• Stephen Neil Kissinger, M.D.
• Nina Kitchen, LCSW
• Dawn Klausmeier, CCLS
• Courtney Kleiber, BCBA, MED
• Bentley Lauren Klein, NP

• General Practice Dentistry in Roswell, GA
• Providers in Roswell, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.