Ada S Tiller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17680 Issued in TX

Practice address

14205 N Mo Pac Expy
Suite 100
Austin, TX 78728-6527

Phone

(512) 218-1130

Fax

(512) 218-4423

NPI assigned

Feb 27, 2007

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

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871620153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 HAMLET CIR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646132",
            "telephone_number": "512-218-1130",
            "fax_number": "512-218-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14205 N MO PAC EXPY",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787286527",
            "telephone_number": "512-218-1130",
            "fax_number": "512-218-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "ADA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Antonio Tijerina, L.S.A.
• Heather Kirsten Tilbury, LCSW-S; RPT-S
• Nancy Tilelli, CHHC
• Leah Tillas
• Marie Tillema, PHARM.D.
• Jennifer L Tiller, APRN, CPNP-PC
• Evita Tilley
• Sitthivanh Tilley, LPC
• Laurel Ann Tillman
• Rachael Tillman

• General Practice Dentistry in Austin, TX
• Providers in Austin, 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 Jul 8, 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.