Active NPI
Tyler Brady, DMD
- General Practice Dentistry
- Hurst, TX
National Provider Identifier
1932550076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 31937
- Practice address
- 808 NE Mall Blvd
Hurst, TX 76053-4653 - Phone
- (817) 595-9675
- NPI assigned
- Jun 30, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31937 | TX | Primary |
Addresses
Primary practice location
808 NE Mall Blvd
Hurst, TX 76053-4653
Mailing address
5436 Chinkapin LN
Fort Worth, TX 76244-6783
Phone (503) 312-1598
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 |
|---|---|---|---|
| 31937 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Care Northeast, PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467244800000",
"number": "1932550076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5436 CHINKAPIN LN",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762446783",
"telephone_number": "503-312-1598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 NE MALL BLVD",
"city": "HURST",
"state": "TX",
"postal_code": "760534653",
"telephone_number": "817-595-9675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "TYLER",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-30",
"last_updated": "2016-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "31937",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hurst, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.