Individual provider Active NPI

Tyler Ames Stocker, DDS

  • Dentist
  • Mont Belvieu, TX
National Provider Identifier
1902535511
Registry record updated Jun 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38541 Issued in TX
Practice address
9205 Eagle Dr Ste 100
Mont Belvieu, TX 77523-5620
Phone
(281) 241-4249
NPI assigned
Jun 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38541 TX Primary

Addresses

Primary practice location

9205 Eagle Dr Ste 100
Mont Belvieu, TX 77523-5620

Mailing address

808 Charleston Dr
Victoria, TX 77904-3822
Phone (361) 212-4689

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

LicenseStateTypeSpecialty
38541TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1902535511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 CHARLESTON DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779043822",
            "telephone_number": "361-212-4689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 EAGLE DR STE 100",
            "city": "MONT BELVIEU",
            "state": "TX",
            "postal_code": "775235620",
            "telephone_number": "281-241-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKER",
        "first_name": "TYLER",
        "middle_name": "AMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mont Belvieu, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.