Alexander Jacob Tyburski, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN4812 Issued in ME

Practice address

327 North Avenue
Skowhegan, ME 04976

Phone

(207) 474-8588

NPI assigned

Jun 30, 2020

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 and National Provider Directory roles.

• Northwoods Dental, LLC

  • Dental Clinic/Center
  • Skowhegan, ME
  • NPI 1851035828
  NPD Authorized official
• Northwoods Dental LLC

  • Dentist
  • Skowhegan, ME
  • NPI 1033574348
  NPD (past)

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1922625573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 411",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760411",
            "telephone_number": "207-474-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 NORTH AVENUE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "04976",
            "telephone_number": "207-474-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYBURSKI",
        "first_name": "ALEXANDER",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Anne Tracy, COTA/L
• Alexander Nmi Turbyne III, D.M.D.
• Brittney M Turner, DPT
• Joshua Neil Turner, LMSW-CC
• Brianna Lee Tweedie
• Tyks Chiropractic, Inc
• Stephen Louis Tyks, DC
• Amanda M Underwood, PA-C
• Nathan Vanderwoude, DPT
• Anthony Vandyck, M.D.

• General Practice Dentistry in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.