Thad Harold Gillespie, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12655 Issued in TX

Practice address

14933 W State Highway 29
Liberty Hill, TX 78642-4323

Phone

(512) 515-0171

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Liberty Hill Dental 2, PLLC

  • Dentist
  • Liberty Hill, TX
  • NPI 1184703316
  NPD (past)

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425340800000",
    "number": "1801847710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 COLE DR",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14933 W STATE HIGHWAY 29",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786424323",
            "telephone_number": "512-515-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "THAD",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2015-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "12655",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "12655",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184703316",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gavino Dermatology, PLLC
• Alde Carlo Patdu Gavino, M.D.
• Sheri Gaynor, RN
• Tiffany Georgiefski, D.D.S
• Kerstin Holl Gillespie, DNP, APRN, FNP-BC
• Great Hills Eye Care, PC
• Samantha Haag, RN, IBCLC
• Nickolas Hadley Jr., DO
• Katie Haines, FNP-C
• Tracy Hall, RPSGT, CCSH

• General Practice Dentistry in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2015; 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.