Doctor profile · Federal record
Dr. Tylen Haderlie, DDS
Dentist · Knoxville, TN
- NPI 1558711010
- 10 yrs on file
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
5315 Fountain RD Ste A
Knoxville, TN 379183094
(865) 687-6763
fax (865) 688-8503 - Additional location
-
10205 N Riva Ridge Loop
Fort Drum, NY 136025457
(315) 772-6234
Credentials & registration
- NPI registered
- June 2016 — 10 yrs on file
- Profile last updated
- September 11, 2025
- Specialty taxonomy
- 122300000X — NUCC code
- State license (1)
- Missouri #2016017398
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1558711010. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$101
Transactions
3
Manufacturers
3
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Coltene Whaledent INC. | 1 | $54.45 | |
| Straumann USA LLC | 1 | $34.05 | |
| Align Technology, INC. | 1 | $12.27 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
20
Patients
12
Total drug cost
$110
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Chlorhexidine Gluconate | Generic | 20 | 12 | $110 |
Frequently asked questions
What is Dr. Tylen Haderlie's medical specialty?
Dr. Tylen Haderlie practices Dentist in Knoxville, TN.
Where does Dr. Tylen Haderlie practice?
Dr. Tylen Haderlie practices at 5315 Fountain RD Ste A, Knoxville, TN 379183094. Office phone: 8656876763.
What is Dr. Tylen Haderlie's NPI?
Dr. Tylen Haderlie's National Provider Identifier (NPI) is 1558711010, issued by NPPES.