Chester J Tyson in Wilmington - Pediatric Dentistry
Chester J Tyson - NPI 1003970534
Chester J Tyson is a Pediatric Dentistry in Wilmington, North Carolina. Chester J Tyson practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Chester J Tyson is 1003970534. The last update date is 2007-07-08.
Chester J Tyson's current location address is 2606 Iron Gate Dr, Wilmington, North Carolina. You can contact this provider via phone number 9107917380 and fax number 9107918160. The mailing address for Chester J Tyson is 2606 Iron Gate Dr, Wilmington, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Chester J Tyson |
|---|---|
| Address | 2606 Iron Gate Dr, Wilmington, North Carolina |
| Phone Number | 9107917380 |
| Fax Number | 9107918160 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1003970534 |
|---|---|
| Provider Enumeration Date | 2006-12-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2606 Iron Gate Dr |
|---|---|
| City | Wilmington |
| State | North Carolina (NC) |
| Post Code | 284122573 |
| Phone Number | 9107917380 |
| Fax Number | 9107918160 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 6504 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9003C | NC | -- |
Post Comment/ Review Below
What is the Chester J Tyson's unique identification number?
The Chester J Tyson has been assigned the NPI (National Provider Identifier) Number 1003970534 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Where is the Chester J Tyson located?
The Chester J Tyson is located at 2606 Iron Gate Dr, Wilmington, NC 284122573.
What is Chester J Tyson's specialized field of practice, and what is the corresponding taxonomy classification code?
The Chester J Tyson's area of specialization is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this field of practice is 1223P0221X.
On what date did the Chester J Tyson receive the assignment of its 1003970534 from the Centers for Medicare & Medicaid Services?
The Chester J Tyson was issued its 1003970534 by the Centers for Medicare & Medicaid Services on 2006-12-20.
When was the information regarding Chester J Tyson, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Chester J Tyson, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA