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TYLER PERIODONTICS PLLC NPI 1619331634


NPI Information

NPI: 1619331634
Provider Name: TYLER PERIODONTICS, PLLC

Former Legal Business Name: JOHN E. ADCOCK DDS MS

Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
3805 BROOKSIDE DR
TYLER, TX
ZIP 75701
Phone: (903) 581-2900
Get Directions

TYLER PERIODONTICS, PLLC is a periodontics dentist in Tyler, TX. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. TYLER PERIODONTICS, PLLC NPI is 1619331634. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is John E. Adcock Dds Ms.

The provider's business location address is:

3805 BROOKSIDE DR
TYLER, TX
ZIP 75701-421
Phone: (903) 581-2900
Fax: (903) 509-0160

The provider's authorized official is Rhonda Worthen .
The authorized official title is Business Manager and has the following contact phone number (903) 581-2900.

The enumeration date for this NPI number is 4/6/2016 and was last updated on 12/22/2016.


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
11223P0300XDentistPeriodontics30701TEXASYes
21223P0300XDentistPeriodontics10911TEXASNo

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: 5/5/2024

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