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TYLER PERIODONTICS, PLLC
NPI 1619331634
Dentist - Periodontics in Tyler, TX

Active since April 06, 2016
3805 BROOKSIDE DR, TYLER, TX 75701(903) 581-2900(903) 509-0160 Get Directions Write a Review

NPPES record last updated: December 22, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tyler Periodontics, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER PERIODONTICS, PLLC (NPI 1619331634), doing business as John E. Adcock Dds Ms, is a healthcare organization registered as a periodontics in Tyler, Texas and active in the NPI registry since April 2016. The organization lists Rhonda Worthen, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1619331634
Entity TypeOrganization
Primary Taxonomy1223P0300X
Legal Business NameTYLER PERIODONTICS, PLLC
Location Address3805 BROOKSIDE DRTyler, TX 75701-9421
Mailing Address3805 Brookside DrTyler, TX 75701-9421 · (903) 581-2900 · Fax (903) 509-0160
Phone(903) 581-2900
Fax(903) 509-0160
Organization SubpartNo
Authorized OfficialRhonda WorthenBusiness Manager · (903) 581-2900
Enumeration DateApril 6, 2016
Last NPPES UpdateDecember 22, 2016
✔ NPI 1619331634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
Licenses✔ Licensed in TX · 30701✔ Licensed in TX · 10911
Definition
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.
3805 BROOKSIDE DR, Tyler, TX 75701
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Other Names 1

Former Legal Business NameJohn E. Adcock Dds Ms

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ALEXANDRA RICKER KENNEDY DDS, MS
Dentist (Periodontics)
3805 BROOKSIDE DR
TYLER, TX 75701
Smith County (903) 581-2900
DR. JOHN E. ADCOCK D.D.S., M.S.
Dentist (Periodontics)
3805 BROOKSIDE DR
TYLER, TX 75701
Smith County (903) 288-8805

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyler Periodontics, PLLC's NPI number?

The NPI number for Tyler Periodontics, PLLC is 1619331634. It was assigned to this organization in the NPPES registry on April 6, 2016. The provider was formerly known as John E. Adcock Dds Ms.

Where is Tyler Periodontics, PLLC located?

Tyler Periodontics, PLLC is located at 3805 Brookside Dr, Tyler, TX 75701. The listed phone number is (903) 581-2900.

What is Tyler Periodontics, PLLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

When was this NPI record last updated?

The NPPES record for Tyler Periodontics, PLLC was last updated on December 22, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.