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TYLER NELSON DDS CORP. NPI 1134730914


NPI Information

NPI: 1134730914
Provider Name: TYLER NELSON, DDS, CORP.
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
955 BOARDWALK STE 103
SAN MARCOS, CA
ZIP 92078
Phone: (760) 644-5494
Get Directions

TYLER NELSON, DDS, CORP. is an oral and maxillofacial surgery dentist in San Marcos, CA. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. TYLER NELSON, DDS, CORP. NPI is 1134730914. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

955 BOARDWALK STE 103
SAN MARCOS, CA
ZIP 92078-659
Phone: (760) 644-5494

The provider's authorized official is Tyler Nelson .
The authorized official title is Owner and has the following contact phone number (719) 722-0540.

The enumeration date for this NPI number is 8/13/2020 and was last updated on 9/1/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11790093599OTHERGUARDIAN, DELTA DENTAL, UNITED CONCORDIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.