Stephanie Till, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12143 Issued in TN

Practice address

150 Clinic Dr Ste 1
Kingsport, TN 37663-2254

Phone

(423) 722-8833

NPI assigned

Nov 25, 2020

Last updated

Aug 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1659975084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CLINIC DR STE 1",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632254",
            "telephone_number": "423-722-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC DR STE 1",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632254",
            "telephone_number": "423-722-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILL",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401416685",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TN",
            "license": "12143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriel Ian Guthrie Thompson, PHARMD, MS
• Grant Cole Thompson, PA
• Kelly Lauren Thompson, NP
• Sharon Lyn Thouin, RN, BSN.,CST,CRC
• Three Rivers Physiatry PLLC
• Tara M Tilton I, PA-C
• Madison Tincher, DPT
• April Dawn Tipton, BS
• Kristy Mae Tipton, LPC
• Ransom Tipton II, PTA

• Periodontics in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Periodontics in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.