Provider Demographics
NPI:1003301458
Name:ORN, TYLER RAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:RAY
Last Name:ORN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 COPPERCREST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2565
Mailing Address - Country:US
Mailing Address - Phone:328-282-3328
Mailing Address - Fax:
Practice Address - Street 1:9595 SIX PINES DR STE 1370
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-1540
Practice Address - Country:US
Practice Address - Phone:281-298-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34117OtherTSBDE