Provider Demographics
NPI:1487547675
Name:CASENHISER, CAMERON TYLER (DMD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:TYLER
Last Name:CASENHISER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 GRIFFIN ROAD
Mailing Address - Street 2:23RD DENTAL COMPANY
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92278
Mailing Address - Country:US
Mailing Address - Phone:760-830-2117
Mailing Address - Fax:
Practice Address - Street 1:1591 GRIFFIN ROAD
Practice Address - Street 2:23RD DENTAL COMPANY
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278
Practice Address - Country:US
Practice Address - Phone:760-830-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-29
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program