Tyler Benton Blount, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10098 Issued in KY

Practice address

8013 New la Grange Rd Ste 6
Louisville, KY 40222-4700

Phone

(502) 425-7068

NPI assigned

May 17, 2018

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 KY

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

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1992295653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MCARTHUR DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402072265",
            "telephone_number": "502-396-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 NEW LA GRANGE RD STE 6",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224700",
            "telephone_number": "502-425-7068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Preston St Rm 148",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021701",
            "country_code": "US",
            "telephone_number": "502-852-3534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOUNT",
        "first_name": "TYLER",
        "middle_name": "BENTON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blossom Tree Healthcare LLC
• Blossom Tree Home Care LLC
• Carole A Blough, MSSW
• David Benton Blount, DMD
• Mariah Blount, PTA
• Deborah Lynn Bloyd, NURSE PRACTITIONER
• Blu Well of Kentucky LLC
• Blue Grass Diagnostics
• Blue Horizon Home Care Agency LLC
• Blue Lick Recovery

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2019; 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.