Individual provider Active NPI

Murrell Stephen Tull Jr., D.D.S

  • Dentist
  • Dalton, GA
National Provider Identifier
1386735439
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN11960 Issued in GA
Practice address
1017 Riverburch Pkwy
Dalton, GA 30721-8676
Phone
(706) 226-6153
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN11960 GA Primary

Addresses

Primary practice location

1017 Riverburch Pkwy
Dalton, GA 30721-8676

Mailing address

1017 Riverburch Parkway
Dalton, GA 30721
Phone (706) 226-6153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250513000530 GA Practitioner - Dentist 0941676167 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN11960GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Sleep Solutions, LLC Dentist CurrentSince Sep 15, 2022 Accepting new patients

Locations

1017 Riverburch Pkwy
Dalton, GA 30721
Phone (706) 226-6153

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386735439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 RIVERBURCH PARKWAY",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30721",
            "telephone_number": "706-226-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 RIVERBURCH PKWY",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218676",
            "telephone_number": "706-226-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "MURRELL",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN11960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.