TYLER NELSON, DDS, CORP. (NPI# 1134730914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134730914 |
| Entity Type | Organization |
| Organization Name | TYLER NELSON, DDS, CORP. |
| Practice Address |
955 Boardwalk Ste 103 San Marcos CA 92078-2659 |
| Practice Telephone | 7606445494 |
| Mailing Telephone | 7606445494 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | TYLER NELSON (OWNER) |
| Authorized Official Telephone | 7197220540 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GUARDIAN, DELTA DENTAL, UNITED CONCORDIA | 1790093599 | 01 |
| Street Address |
955 BOARDWALK STE 103 |
| City | SAN MARCOS |
| State | CA |
| Zip Code | 92078-2659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861403958 | Michael Zane Mcbride | Dentist | 955 Boardwalk Ste 103, San Marcos, CA 92078-2659 | 2006-08-11 |
| 1275010506 | Michael Z Mcbride Dds | Clinic/Center | 955 Boardwalk Ste 103, San Marcos, CA 92078-2659 | 2018-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437623253 | Tania Borja-rodriguez | Nurse Practitioner | 334 Via Vera Cruz #257, San Marcos, CA 92078 | 2019-01-15 |
| 1558846824 | Mckenzie Daile Sorensen | Dentist | 145 S Las Posas Rd Ste 162, San Marcos, CA 92078 | 2018-10-02 |
| 1548750169 | West2north Medical Solutions Inc | Physical Medicine & Rehabilitation | 1595 Grand Ave Ste 100, San Marcos, CA 92078 | 2018-05-18 |
| 1700385747 | Wytoshery Monea Williams | Nurse Practitioner | 1912 Northstar Way, 130, San Marcos, CA 92078 | 2018-02-05 |
| 1457878415 | Smile Community Clinic Inc | Dentist | 670 W. San Marcos Blvd. Ste 103-b, San Marcos, CA 92078 | 2017-08-29 |
| 1740636232 | Ethelaine Centeno | Occupational Therapist | 1615 S. Rancho Santa Fe Road, San Marcos, CA 92078 | 2016-05-13 |
| 1336506203 | Nga Thien Ta | Pharmacist | 671 Rancho Santa Fe, San Marcos, CA 92078 | 2016-01-24 |
| 1689039349 | Kayleigh Ann Desrosiers | Physical Therapist | 137 S Las Posas Rd Ste 254, San Marcos, CA 92078 | 2015-12-23 |
| 1821475930 | Anna Yu | Social Worker | 310 S. Twin Oaks Valley Rd., #107-381, San Marcos, CA 92078 | 2015-04-28 |
| 1831582592 | Bewell Home Physical Therapy P C | Clinic/Center | 1582 W San Marcos Blvd Ste 105b, San Marcos, CA 92078 | 2015-03-05 |
| Find all providers in zip 92078 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| 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. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902306384 | Carus Dental | Dentist | 102 Wonder World Dr Ste 101, San Marcos, TX 78666-6080 | 2018-02-13 |
| 1740563253 | Thomas Vincent Brislin Jr. | Dentist | 2057 Silverado St, San Marcos, CA 92078-3201 | 2011-09-21 |
| 1952608291 | Ted Wassel | Dentist | 1030 La Bonita Dr, Suite 322, San Marcos, CA 92078-5291 | 2011-02-23 |
| 1992726681 | Donald Paul Bandy | Dentist | 4127 Day Dr., San Marcos, TX 78666-9540 | 2006-07-21 |
| 1902914021 | Kouros Izadi | Dentist | 709 Center Dr, Ste. 101, San Marcos, CA 92069-3536 | 2006-08-28 |
| 1871566984 | George M Grant | Dentist | 310 Stagecoach Trl, Suite 600, San Marcos, TX 78666-5134 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
| City | SAN MARCOS |
| Zip Code | 92078 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.