NPIMap

Organization Active NPI

Tyler M. Davis DDS PA

  • Durable Medical Equipment & Medical Supplies
  • Wake Forest, NC
National Provider Identifier
1982191789
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
TYLER M. DAVIS DDS PA
Practice address
814 S Main St
Wake Forest, NC 27587-2808
Phone
(919) 556-3780
NPI assigned
Apr 17, 2018
Last updated
Sep 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Dr. Tyler Matheson Davis, DDSNPI 1104053057
Title
Dentist
Phone
(919) 556-3780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8811 NC
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

814 S Main St
Wake Forest, NC 27587-2808

Mailing address

814 S Main St
Wake Forest, NC 27587-2808
Phone (919) 556-3780

Other names 3

  • Davis, Tyler Other name
  • Dr. Tyler Matheson Davis DDS Other name
  • Tyler M. Davis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180523002654 NC DME Supplier - Oral Surgery - Dentist 6507126182 Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory
Tax ID family
Davis Tyler3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

814 S Main St
Wake Forest, NC 27587
Phone (919) 556-3780

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1982191789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872808",
            "telephone_number": "919-556-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872808",
            "telephone_number": "919-556-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER M. DAVIS DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "MATHESON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "919-556-3780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "8811",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davis, Tyler",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Davis, Tyler",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Dr. Tyler Matheson Davis DDS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tyler M. Davis",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.