Kenneth Tilles, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0641 Issued in MD

Legal business name

KENNETH TILLES, O.D., P.A.

Practice address

825 Dulaney Valley Rd
Suite 264
Towson, MD 21204-1010

Phone

(410) 828-4133

Fax

(410) 828-4646

NPI assigned

Mar 4, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Tilles, O.D.

Title

President

Phone

(410) 828-4132

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1330819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1679847974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DULANEY VALLEY RD",
            "address_2": "SUITE 264",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212041010",
            "telephone_number": "410-828-4133",
            "fax_number": "410-828-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DULANEY VALLEY RD",
            "address_2": "SUITE 264",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212041010",
            "telephone_number": "410-828-4133",
            "fax_number": "410-828-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH TILLES, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-04",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "TILLES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-828-4132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MD",
            "license": "0641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Towson, MD
• Providers in Towson, MD by specialty
• Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.