Michael F. Tillery DDS & Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7704 Issued in IN

Legal business name

MICHAEL F. TILLERY DDS & ASSOCIATES PC

Practice address

3410 N High School Rd Ste B
Indianapolis, IN 46224-0002

Phone

(317) 291-8957

Fax

(317) 291-2115

NPI assigned

May 6, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Michael Fredrick Tillery, DDSNPI 1356494462

Title

Owner

Phone

(317) 291-8957

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Fredrick Tillery, D.D.S.

  • Dentist
  • Indianapolis, IN
  • NPI 1356494462
  NPD (past) Authorized official
• Steven M Lenos

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1003988692
  NPD (past)
• Torie Lynn Richardson, DDS

  • Dentist
  • Alexandria, IN
  • NPI 1467980284
  NPD (past)
• Stephen K Williams, D.D.S.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1558498774
  NPD (past)

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1609286061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 N HIGH SCHOOL RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462240002",
            "telephone_number": "317-291-8957",
            "fax_number": "317-291-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 N HIGH SCHOOL RD STE B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462240002",
            "telephone_number": "317-291-8957",
            "fax_number": "317-291-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL F. TILLERY DDS & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "FREDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-291-8957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "7704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100062710A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taimur Khalid Mian, MD
• Micah 68 Corporation (Direct Link)
• Micare Home Health Services, LLC
• Michael a. Davis, D.D.S. Family Dental LLC
• Michael a. Rice DDS PC
• Michael J Gerstbauer DDS, PC
• Michael J Helms DPM LLC
• Erin Lynn Michael Jolliff, MSW, LCSW
• Michael Maksimovich LCSW LLC (Michael Maksimovich)
• Michael N. Harris, DDS, P.C.

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.