DOUGLAS W. TILLERY (NPI# 1033120001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033120001 |
| Entity Type | Individual |
| Full Name | DOUGLAS W. TILLERY |
| Credential | DDS |
| Practice Address |
1508 W 10th St Laurel MS 39440-2668 |
| Practice Telephone | 6014286093 |
| Practice Fax Number | 6014286096 |
| Mailing Telephone | 6014286093 |
| Mailing Fax Number | 6014286096 |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | MS133268 | MS | Dental Providers |
| Street Address |
1508 W 10TH ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-2668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678992 | Michael Moran | Dentist | 1508 W 10th St, Laurel, MS 39440-2668 | 2019-06-13 |
| 1508216888 | Travis Ball | Dentist | 1508 W 10th St, Laurel, MS 39440-2668 | 2016-06-16 |
| 1689050262 | Trevor Hall | Dentist | 1508 W 10th St, Laurel, MS 39440-2668 | 2015-08-05 |
| 1376656041 | Tillery Dental Clinics, P.a. | Dentist | 1508 W 10th St, Laurel, MS 39440-2668 | 2006-08-16 |
| 1538171566 | John M Chandler | Dentist | 1508 W 10th St, Laurel, MS 39440-2668 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205480373 | Cibele Lima Raimondo, Dds, LLC | Dentist | 649 Main St # A, Laurel, MD 20707-4066 | 2019-07-28 |
| 1629561758 | Fernando M Archuleta | Dentist | 535 Main St Ste 113, Laurel, MD 20707-4335 | 2018-06-13 |
| 1134640683 | Dorothy Stancill | Dentist | 1434 Parker Dr, Laurel, MS 39440-1942 | 2017-07-05 |
| 1124479647 | Ghata D Patel | Dentist | 9072 Manorwood Rd, Laurel, MD 20723 | 2016-06-27 |
| 1750757597 | Fusion Dental | Dentist | 14722 Baltimore Ave, Suite 103, Laurel, MD 20707-4872 | 2015-08-17 |
| 1861832834 | Cody Warner Winterholler | Dentist | 413 Se 4th St, Winterholler Dentistry, Laurel, MT 59044-3317 | 2013-07-04 |
| 1578900718 | Smile Designers LLC | Dentist | 1709 W 20th St, Laurel, MS 39440-1802 | 2013-05-29 |
| 1164770442 | Amy Sellers Morgan | Dentist | 1925 Pine Belt Dr, Laurel, MS 39440-1348 | 2012-08-17 |
| 1871883595 | Hina Rani Goyal | Dentist | 8312 Sweet Cherry Ln, Laurel, MD 20723-1060 | 2011-04-14 |
| 1457665036 | Gregory O. Catchings | Dentist | 15505 Clayburn Dr, Laurel, MD 20707-5415 | 2010-08-05 |
| Find all providers in LAUREL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.