NPIMap

Organization Active NPI

Heather Killebrew Tutor, DMD, PA

  • Dentist
  • Lexington, MS
National Provider Identifier
1205082963
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3145-00 Issued in MS
Legal business name
HEATHER KILLEBREW TUTOR, DMD, PA
Practice address
302 Court Square
Lexington, MS 39095
Phone
(662) 834-9899
Fax
(662) 834-9895
NPI assigned
Aug 13, 2008
Last updated
Jan 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Authorized official

Name
Dr. Heather Killebrew Tutor, DMDNPI 1043220312
Title
Owner
Phone
(662) 834-9899

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3145-00 MS Primary

Addresses

Primary practice location

302 Court Square
Lexington, MS 39095

Mailing address

302 Court Square
Lexington, MS 39095
Phone (662) 834-9899

Other identifiers 1

IdentifierTypeStateIssuer
09015878MedicaidMS

National Provider Directory

National Provider Directory

Locations

302 Court Sq
Lexington, MS 39095
Phone (662) 834-9899

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1205082963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 COURT SQUARE",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "39095",
            "telephone_number": "662-834-9899",
            "fax_number": "662-834-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 COURT SQUARE",
            "city": "LEXINGTON",
            "state": "MS",
            "postal_code": "39095",
            "telephone_number": "662-834-9899",
            "fax_number": "662-834-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER KILLEBREW TUTOR, DMD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "TUTOR",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "KILLEBREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-834-9899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3145-00",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015878",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2017; 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.