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Active NPI 1306737531 Individual Practitioner Male Practitioner

Dr. Mazen Atout , DMD

Dentist - General Practice • Tyler, TX

Professional Overview & Biography Verified Profile Summary

Dr. Mazen Atout, DMD is a registered healthcare professional specializing in Dentist - General Practice in Tyler, TX. Practice services are available at 5605 OLD BULLARD RD STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5605 Old Bullard Rd Ste A

Tyler, TX 757034306

Telephone 9037473919
Associated Practice Facility / Clinic
🏢 Alpha First Dental Clinic P.a Facility NPI 1720325418

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
84 Specialists

Practicing in Tyler, TX (10570 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-16
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 42345

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License CA 113107

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Dentist

NUCC Taxonomy Code: 122300000X

State License TX 42345

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Secondary Practice Locations

1584 W Base Line St Ste 103

San Bernardino, CA 924111746

Phone: 9098853100

1744 University Ave Ste 102

Riverside, CA 925075364

Phone: 9517829585

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Luke Dlabal , DDS

Dentist - General Practice

NPI 1023323896

Doctor of Dental Surgery

Dr. Antony Odhiambo , DDS

Dentist - General Practice

NPI 1073740478

Doctor of Dental Surgery

Atul Bidarkar

Dentist - General Practice

NPI 1194294926

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location July 16, 2026

Registered at 5605 OLD BULLARD RD STE A, TYLER, TX 757034306 (Tel: 9037473919)

📍
Updated Business Mailing Address July 16, 2026

Registered at 5605 OLD BULLARD RD, TYLER, TX 757034306 (Tel: 9037473919)

📍
Updated Practice Location July 08, 2026

Registered at 5605 OLD BULLARD RD, TYLER, TX 757034306 (Tel: 9037473919)

📍
Updated Business Mailing Address July 08, 2026

Registered at 611 W HOUSTON ST, TYLER, TX 757027924 (Tel: 8595390217)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2026

Dentist (License #42345 in TX)

NPI Profile Active July 15, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location July 15, 2025

Registered at 400 LUCERA CT APT 107, POMONA, CA 917666803 (Tel: 8595390217)

📍
Updated Business Mailing Address July 15, 2025

Registered at 400 LUCERA CT APT 107, POMONA, CA 917666803 (Tel: 8595390217)

👤
Provider Name / Credentials Updated July 15, 2025

Recorded as MAZEN ATOUT, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2025

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration July 15, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306737531
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2025
Last Update: July 16, 2026
Sole Proprietor: Yes

Mailing Address

5605 Old Bullard Rd

Tyler, TX 757034306

Phone: 9037473919

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.