MEDICARE: DR. TY ALLEN MAYS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6924	OK
2	1223D0004X	Dental Anesthesiology	142031539924	UT
3	390200000X	Student in an Organized Health Care Education/Training Program	061661	NY

General Provider Information

NPI Number	:	1790213486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TY ALLEN MAYS DDS

Provider Business Mailing Address
First Line	:	1106 S REDWOOD RD # D21
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84104-3308
Country	:	US
Telephone Number	:	580-302-3726
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 W ARLINGTON AVE
Second Line	:
City	:	WEATHERFORD
State	:	OK
Zip	:	73096-2845
Country	:	US
Telephone Number	:	580-302-3726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2017
Last Update Date	:	01/29/2026

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