# TYSON TEEPLES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952505984
- **Gender:** Man
- **Credential:** DMD, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | D9701 | OR | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DE60266972 | WA | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 60266972 | WA | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | D12473 | MN | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | D9701 | OR | — |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 06/13/2007
- **Last updated:** 11/25/2014