Healthcare Provider Details

I. General information

NPI: 1992616551
Provider Name (Legal Business Name): TYLER FYFE, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W JACKSON BLVD STE 7
JONESBOROUGH TN
37659-5397
US

IV. Provider business mailing address

1000 W JACKSON BLVD STE 7
JONESBOROUGH TN
37659-5397
US

V. Phone/Fax

Practice location:
  • Phone: 423-788-0118
  • Fax:
Mailing address:
  • Phone: 423-788-0118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TYLER JAMES FYFE
Title or Position: OWNER
Credential: DMD
Phone: 209-352-8715