Tyler Anthony Louis Mann, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD2802 Issued in NM

Practice address

4641 Frontier Plaza Dr.
Wasilla, AK 99654

Phone

(907) 373-2227

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tyler.mann.2@27018.direct.athenahealth.com

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.

• Mann Family Dental, LLC

  • Dental Clinic/Center
  • Wasilla, AK
  • NPI 1790205763
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1942318738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 E FRONTIER PLAZA DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546044",
            "telephone_number": "907-373-2227",
            "fax_number": "888-357-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 FRONTIER PLAZA DR.",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-373-2227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3341 E Palmdale Dr # 1",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996546044",
            "country_code": "US",
            "telephone_number": "907-373-2227",
            "fax_number": "888-357-2588",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 N Butler Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874016429",
            "country_code": "US",
            "telephone_number": "505-564-4470",
            "fax_number": "505-325-9707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 N Butler Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874016429",
            "country_code": "US",
            "telephone_number": "505-564-4470",
            "fax_number": "505-325-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANN",
        "first_name": "TYLER",
        "middle_name": "ANTHONY LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-11-08",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD2802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1676111",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debby L Maloney, FNP-BC
• Jordan Manelick
• Ryan Duane Mangum, D.C.
• Mann Family Dental, LLC
• Leonard Leroy Mann
• Sophia Marie Mannhardt
• Devon Manning
• Kharlie D Manning
• Steven W Manning, RBT
• Cynthia J Mantey, APNP

• General Practice Dentistry in Wasilla, AK
• Providers in Wasilla, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.