Active NPI
Steven Kent Tilley, DDS
- Dentist
- Creston, IA
National Provider Identifier
1356411219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 05730
- Practice address
- 304 West Lucas
Creston, IA 50801 - Phone
- (641) 782-4747
- Fax
- (641) 782-8004
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 05730 | IA | Primary |
Addresses
Primary practice location
304 West Lucas
Creston, IA 50801
Mailing address
304 West Lucas
Creston, IA 50801
Phone (641) 782-4747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0064956 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05730 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356411219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 WEST LUCAS",
"city": "CRESTON",
"state": "IA",
"postal_code": "50801",
"telephone_number": "641-782-4747",
"fax_number": "641-782-8004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 WEST LUCAS",
"city": "CRESTON",
"state": "IA",
"postal_code": "50801",
"telephone_number": "641-782-4747",
"fax_number": "641-782-8004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TILLEY",
"first_name": "STEVEN",
"middle_name": "KENT",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "05730",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0064956",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Creston, IA
- Swfac PLC (Southwest Foot and Ankle Center PLC)
- Stacy Lynn Tallman, LMSW
- Theresa R Bensky LLC
- Linda S Thomsen, O.D.
- Trey Matthew Thomsen, OD
- Robert Bruce Tipling Jr., LMHC
- Emily A Turner, ARNP
- Union Co Greater Community Physician Clinics
- Visiting Nurse Services of Iowa (EveryStep)
- Wal-Mart Stores, Inc. (Vision Center 30-1435)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.