Tiffany Townsel, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.031401 Issued in IL

Practice address

567 W 14TH St Unit C
Chicago Heights, IL 60411-2323

Phone

(708) 747-7817

NPI assigned

May 13, 2016

Reactivated

Nov 29, 2017

Last updated

Mar 17, 2018By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tiffany.townsel.p1@direct.northshorehealth.nextgenshare.com

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699121186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 MEADOW LAKE DR",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711190",
            "telephone_number": "708-743-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 W 14TH ST UNIT C",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604112323",
            "telephone_number": "708-747-7817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Dr Db Todd Jr Blvd",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372083501",
            "country_code": "US",
            "telephone_number": "708-743-8183",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOWNSEL",
        "first_name": "TIFFANY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2018-03-17",
        "deactivation_date": "2017-11-10",
        "reactivation_date": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Chicago Heights, IL
• Providers in Chicago Heights, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.