Larry F Tilley DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

4819 Issued in NC

Legal business name

LARRY F TILLEY DDS PA

Practice address

3372 Six Forks Road
Raleigh, NC 27609-7209

Phone

(919) 787-0056

Fax

(919) 787-3225

NPI assigned

Jun 24, 2008

Last updated

Jun 24, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Larry Felton Tilley, DDS

Title

President

Phone

(919) 787-0056

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1164683918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 SIX FORKS ROAD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097209",
            "telephone_number": "919-787-0056",
            "fax_number": "919-787-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3372 SIX FORKS ROAD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097209",
            "telephone_number": "919-787-0056",
            "fax_number": "919-787-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY F TILLEY DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "FELTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-787-0056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "4819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8998463",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kathleen Larose, DPM
• Larry J Moray, DDS, Ms PLLC VI (Brier Creek Orthodontics)
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• Anne Larsen, LPC, MA
• Darin Larsen, CRNA
• Jeff William Larsen, PTA

• Dentist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.