DR. MARTIN GEORGE TILLEY (NPI# 1134295389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134295389 |
Entity Type | Individual |
Full Name | DR. MARTIN GEORGE TILLEY |
Credential | M.D., D.D.S., P.C. |
Practice Address |
516 W 39th St Suite D Tower Plaza Kearney NE 68845-2881 |
Practice Telephone | 3088652577 |
Practice Fax Number | 3082349526 |
Mailing Telephone | 3088652577 |
Mailing Fax Number | 3082349526 |
Enumeration Date | 2006-11-28 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4560 | NE | Dental Providers |
X | 208600000X | Surgery | 16420 | NE | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NE | BLUE CROSS BLUE SHIELD | 5400 | 01 |
NE | 47067456101 | 05 | |
NE | BLUE CROSS BLUE SHIELD | 3663 | 01 |
Street Address |
516 W 39TH ST SUITE D TOWER PLAZA |
City | KEARNEY |
State | NE |
Zip Code | 68845-2881 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780910026 | Martin G. Tilley D.d.s., M.d., P.C. | Dentist | 516 W 39th St, Suite D Tower Plaza, Kearney, NE 68845-2881 | 2009-10-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407465966 | Prairie Meadows Dental, PC | Clinic/Center | 1055 West 56th Street, Kearney, NE 68845 | 2020-07-30 |
1508408584 | Sandhills Oral & Facial Surgery LLC | Clinic/Center | 504 W 42nd Street, Kearney, NE 68845 | 2019-10-11 |
1699252395 | Lindustries, LLC | Clinic/Center | 4107 7th Avenue, Kearney, NE 68845 | 2018-07-25 |
1154846764 | Michele Ekberg | Speech-Language Pathologist | 76 Plaza Boulevard, Kearney, NE 68845 | 2017-08-04 |
1457721706 | Lesa Clifford | Speech-Language Pathologist | 4125 Summitt Rd, Kearney, NE 68845 | 2015-09-30 |
1154703353 | Andrew Michael Prososki | Family Medicine | 2403 West 47 Street Place, Kearney, NE 68845 | 2015-06-24 |
1710395561 | Justin Rethorst | Specialist/Technologist | 2810 West 35th St, Kearney, NE 68845 | 2014-07-24 |
1265877567 | Kearney Regional Medical Center LLC | General Acute Care Hospital | 804 22nd Avenue, Kearney, NE 68845 | 2013-05-01 |
1386906972 | Terry L. Dunlop | Counselor | 2315 W. 39th St., Suite 109, Kearney, NE 68845 | 2012-06-11 |
1437431913 | Sarah Winfield Thibault | Counselor | 3532 West Capital Ave, Grand Island, NE 68845 | 2011-09-12 |
Find all providers in zip 68845 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780910026 | Martin G. Tilley D.d.s., M.d., P.C. | Dentist | 516 W 39th St, Suite D Tower Plaza, Kearney, NE 68845-2881 | 2009-10-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306466081 | Village Pointe Oral Surgery P.C. | Dentist | 17121 Marcy St Ste 102, Omaha, NE 68118-3133 | 2020-04-22 |
1528554466 | Chad Sanders Sloan | Dentist | 984125 Nebraska Medical Center Dept of Omfs, Omaha, NE 68198-0001 | 2018-07-03 |
1740709724 | Christopher Treinen | Dentist | 984125 Ne Med Ctr, Omaha, NE 68198-0001 | 2017-09-12 |
1326402470 | Omaha Oral Surgery, LLC | Dentist | 5040 So 153rd St, Omaha, NE 68137-5067 | 2016-04-05 |
1356772420 | Lincoln Aesthetic & Reconstructive Surgery PC | Dentist | 2222 S 16th St Ste 300, Lincoln, NE 68502-3785 | 2013-11-27 |
1871889154 | Karen Ann Tucker | Dentist | 111 N 175th St Ste 1600, Omaha, NE 68118-0017 | 2011-06-24 |
1245543842 | Chase A Pruitt | Dentist | 5040 S 153rd St, Omaha, NE 68137-5067 | 2010-07-23 |
1760708218 | David J Rallis Dds Md Oral and Maxillofacial Surgery, PC | Dentist | 4110 A Street, Lincoln, NE 68510 | 2010-04-08 |
1760626857 | Facial Dimensions, P.C. | Dentist | 710 W Koenig St, Grand Island, NE 68801-6556 | 2009-04-21 |
1740482090 | L. T. Higgins | Dentist | 7812 Davenport St., Omaha, NE 68114-3629 | 2007-05-31 |
Find all providers with the same taxonomy |
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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.