Ruediger Tillmann, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

142274 Issued in UT

Practice address

5872 S 900 E
202
Salt Lake City, UT 84121-1676

Phone

(801) 281-8433

Fax

(801) 281-8455

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710074646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5872 S 900 E",
            "address_2": "202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211676",
            "telephone_number": "801-281-8433",
            "fax_number": "801-281-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5872 S 900 E",
            "address_2": "202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211676",
            "telephone_number": "801-281-8433",
            "fax_number": "801-281-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMANN",
        "first_name": "RUEDIGER",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "142274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS/MONARCH INSURANCE",
            "identifier": "0196",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC EMPLOYEES  INSURAN",
            "identifier": "14705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA INSURANCE",
            "identifier": "0005762263",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry V. Tiller
• Emily Tillett
• Aubrie Dawn Tilley
• Kathy Tilley
• Lei Loni J Tilley
• Andrea Tillotson
• Shannon L Tilly, MD
• Lloyd V Tilt, DDS,MS
• Joel Dela Cruz Timbol
• Arthur Iulius Timbus, M.D.

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.