Tyler Roberts, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D7586 Issued in AZ

Practice address

1864 E Florence Blvd Ste 1
Casa Grande, AZ 85122-5504

Phone

(520) 350-7560

Fax

(520) 788-6142

NPI assigned

Aug 15, 2008

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment NPD
• Marana Pediatric Dentistry, Tyler Roberts, DMD, PLLC

  • Pediatric Dentistry
  • Mesa, AZ
  • NPI 1174380836
  NPD Authorized official
• San Carlos Apache Healthcare Corporation

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• Sun Life Family Health Center, Inc.

  • Dental Clinic/Center
  • Casa Grande, AZ
  • NPI 1992166359
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982850459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 N ARIZOLA RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226011",
            "telephone_number": "520-836-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 E FLORENCE BLVD STE 1",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225504",
            "telephone_number": "520-350-7560",
            "fax_number": "520-788-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TYLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D7586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nephi Wesley Riordan, D.C.
• RMD Medical LLC
• Rna Property, LLC
• Robert F Hankel Jr DDS LTD
• Robert F. Kasa MD PC
• Kambria Robinson, M.S., TSLP
• Michael Andre Robinson II
• Faustino Robles Jr., PHARMD
• Cheryl Robuck, FNP-C
• Rocky Mountain Holdings LLC

• Pediatric Dentistry in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Pediatric Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.