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

Tyler J Maxwell

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396273298

Tyler J Maxwell is a Student in an Organized Health Care Education/Training Program in Fayetteville, New York. Works from 3 locations. Licensed in New York.

Licensed in
NY
In the registry since
2017
Specialties on file
2

Practice location Address checks out

511 E Genesee St
Fayetteville, NY 13066-1524
Phone: (315) 637-4616
Show map & directions

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

Additional practice locations (2)

  • 90 Presidential Plz, Syracuse, NY 13202-2240 — (315) 464-4148
  • 90 Presidential Plz, Syracuse, NY 13202-2240 — (315) 464-4148

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 059837 (NY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396273298
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 23, 2017
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022
Mailing address511 E Genesee St, Fayetteville, NY 13066-1524

Other providers in Fayetteville