Ernest Joseph Tiller Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013269 Issued in GA

Practice address

2341 Henry Clower Blvd
Snellville, GA 30078-7420

Phone

(770) 736-0099

NPI assigned

Jan 3, 2007

Sex

Male

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 GA

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

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.

• Spelios and Associates Snellville PC

  • Point of Service
  • Snellville, GA
  • NPI 1811047400
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1962569400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 HENRY CLOWER BLVD STE A",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787420",
            "telephone_number": "770-736-0099",
            "fax_number": "770-923-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 HENRY CLOWER BLVD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787420",
            "telephone_number": "770-736-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLER",
        "first_name": "ERNEST",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Thompson, APC
• Patrick Thompson
• Jared Blake Thornhill, OD
• Joseph Patterson Thornton III, D.D.S.
• Jeneifer Threadcraft, LPC
• Time 2 Inspire, LLC
• Timeless Realty Enterprises
• Matthew Tinkham, MD
• Tisha V Tipnis, MD
• John Adam Titak, PHARMD

• General Practice Dentistry in Snellville, GA
• Providers in Snellville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.