Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tyler Periodontics, PLLC

Organization Periodontics · NPI 1619331634

Tyler Periodontics, PLLC is a Periodontics in Tyler, Texas. Licensed in Texas. Registered with an NPI since 2016.

Licensed in
TX
In the registry since
2016
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3805 Brookside Dr
Tyler, TX 75701-9421
Phone: (903) 581-2900
Fax: (903) 509-0160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 30701 (TX)
Periodontics Taxonomy 1223P0300X · Licence 10911 (TX)

Record details

NPI number1619331634
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rhonda Worthen — Business Manager · (903) 581-2900
Other names John E. Adcock Dds Ms
NPI enumeratedApril 6, 2016
Last updated in NPPESDecember 22, 2016
Mailing address3805 Brookside Dr, Tyler, TX 75701-9421

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