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

Tyler Delaurentis

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1013617323

Tyler Delaurentis is a Student in an Organized Health Care Education/Training Program in Boston, Massachusetts. Practices as a sole proprietor. Licensed in Massachusetts.

Licensed in
MA
In the registry since
2023
Specialties on file
2

Practice location Address checks out

20 W 5th St Apt 6D
Boston, MA 02127-3351
Phone: (203) 909-1892
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN10000308 (MA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1013617323
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 6, 2023
Last updated in NPPESNovember 12, 2024
Certification dateNovember 12, 2024
Mailing address20 W 5th St Apt 6d, Boston, MA 02127-3351

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