TYLER OWENS (DMD) – Pediatric Dentistry, NPI 1609268861
Pediatric Dentistry
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TYLER OWENS (DMD)
400 RIVERWALK TER STE 250
JENKS, OK 740375619
Phone: (918) 998-0996
Fax: (918) 235-9079
Type: Mailing
404 S Elm St Ste 108
Jenks, OK 740373714
Phone: (918) 417-2417
Type: Location
2602 S Picher Ave
Joplin, MO 648041641
Phone: (417) 781-2220
Type: Location
3100 E ZORA ST
WEBB CITY, MO 648709770
Phone: (417) 228-8286
Fax: (512) 442-6074
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-04-28
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220428000566 | I | Dentist | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 74037)
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