Tullos Family Dentistry, PA

Primary specialty

DentistTaxonomy code 122300000X

License

3265-03 Issued in MS

Legal business name

TULLOS FAMILY DENTISTRY, PA

Practice address

276 Magnolia Dr
Raleigh, MS 39153-6016

Phone

(601) 782-9909

Fax

(601) 782-9133

NPI assigned

Jan 3, 2007

Last updated

Aug 22, 2020By 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. Stephanie Sullivan Tullos, D.M.D.NPI 1063683472

Title

Dentist

Phone

(601) 782-9909

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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.

• Stephanie Sullivan Tullos, DMD

  • Dentist
  • Raleigh, MS
  • NPI 1063683472
  NPD (past) Authorized official
• Cayla Lloyd Dickerson, DMD

  • Dentist
  • Raleigh, MS
  • NPI 1508693177
  NPD (past)
• Georgia Caroline May Mars, DMD

  • Dentist
  • Raleigh, MS
  • NPI 1619652211
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467519827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 MAGNOLIA DR",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "391536016",
            "telephone_number": "601-782-9909",
            "fax_number": "601-782-9133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 MAGNOLIA DR",
            "city": "RALEIGH",
            "state": "MS",
            "postal_code": "391536016",
            "telephone_number": "601-782-9909",
            "fax_number": "601-782-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULLOS FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TULLOS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "SULLIVAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "601-782-9909",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3265-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00529717",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Darlene Richmond-Stephens, CRNP
• Smith County LTC, LLC
• St Dominic Medical Associates LLC (St Dominic Raleigh Family Practice)
• Phil Thompson, DO
• Cassidy L Thornton, LICSW
• Stephanie Sullivan Tullos, DMD
• Kimberly Sharelle Watkins, FNP-C
• Vaniecia Wilson, DMD
• Alexandra Winn, NP

• Dentist in Raleigh, MS
• Providers in Raleigh, MS by specialty
• Dentist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.