Ty Daniel Lauderdale

Primary specialty

DentistTaxonomy code 122300000X

License

14301988-9926 Issued in UT

Practice address

3145 Garden Ave
San Antonio, TX 78234-7718

Phone

(210) 808-3735

NPI assigned

Apr 7, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1972298719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3145 GARDEN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782347718",
            "telephone_number": "210-808-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 GARDEN AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782347718",
            "telephone_number": "210-808-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDERDALE",
        "first_name": "TY",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-07",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "14301988-9926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon Lau, PH.D.
• Zi Xin Lau
• Brennan Laubach, RBT
• Gary Laudenslager, CCP
• Lauder Enterprises, Inc
• Stefanie Laue, NP
• Logan James Lauffer
• Vanessa Tamara Lauffer, PHARMD
• Joan Elaine Laufman, M.D.
• Maureen Ann Laughlin, ACNP-BC

• Dentist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.