DR. DUTRAN TYLER DO MD DMD NPI 1053490961

NPI Information

  • NPI: 1053490961
  • Provider Name: DR. DUTRAN TYLER DO, MD, DMD
  • Classification: Oral & Maxillofacial Surgery - 204E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 12401 WILSHIRE BLVD STE 104
    LOS ANGELES, CA
    ZIP 90025
  • Phone: (203) 200-7280

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NPI Details

DR. Dutran Tyler Do, MD, DMD is an oral maxillofacial surgery in Los Angeles, CA. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. DR. Dutran Tyler Do, MD, DMD NPI is 1053490961. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12401 WILSHIRE BLVD STE 104
LOS ANGELES, CA
ZIP 90025-015
Phone: (203) 200-7280

The NPI 1053490961 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 2/27/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial SurgeryC139636CALIFORNIAYes
2122300000XDentist052760NEW YORKNo
3122300000XDentist64626CALIFORNIANo
4204E00000XOral & Maxillofacial Surgery049194CONNECTICUTNo
5204E00000XOral & Maxillofacial Surgery257471NEW YORKNo

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: 11/21/2025

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