Tillery Group PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10178 Issued in FL

Legal business name

TILLERY GROUP PA

Practice address

800 W Morse Blvd
Suite 2
Winter Park, FL 32789-3797

Phone

(407) 628-5400

Fax

(407) 628-5389

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Don E Tillery Jr., DMDNPI 1306950274

Title

Owner and Surgeon

Phone

(407) 628-5400

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Don E Tillery Jr., DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Winter Park, FL
  • NPI 1306950274
  NPD (past) Authorized official
• Andonis Terezides, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Orlando, FL
  • NPI 1225199235
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1902020118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 W MORSE BLVD",
            "address_2": "SUITE 2",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893797",
            "telephone_number": "407-628-5400",
            "fax_number": "407-628-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W MORSE BLVD",
            "address_2": "SUITE 2",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893797",
            "telephone_number": "407-628-5400",
            "fax_number": "407-628-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLERY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "TILLERY",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER AND SURGEON",
        "authorized_official_telephone_number": "407-628-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "10178",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "16103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Threshold, Inc.
• Threshold, Inc.
• Krupali Thumu, PHARMD
• Nicole M. Thweatt, PH. D, LMHC
• Carl Michael Tierney, RMHCI
• Don E Tillery Jr., DMD
• Timken Radiology PA
• Tracy Elizabeth Timmer, COTA/L
• Jannet Tineo, B.A
• Kiran Tipirneni, MD

• Oral and Maxillofacial Surgery (Dentist) in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.