MRS. MARYELLEN TILLY (NPI# 1134396914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134396914 |
| Entity Type | Individual |
| Full Name | MRS. MARYELLEN TILLY |
| Credential | RDH BA |
| Practice Address |
15100 Rescue Way Dental Clearwater FL 33762-3502 |
| Practice Telephone | 7275351437 |
| Mailing Telephone | 7275351437 |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 124Q00000X | Dental Hygienist | DH 11169 | FL | Dental Providers |
| Street Address |
15100 RESCUE WAY DENTAL |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33762-3502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841276433 | Esan Odell Simon | Family Medicine | 15100 Rescue Way, Uscg Air Station Clearwater Medical Clinic, Clearwater, FL 33762-3502 | 2005-12-16 |
| 1063819621 | Daniel Coleman | Emergency Medical Technician, Basic | 15100 Rescue Way, Clearwater, FL 33762-3502 | 2014-11-25 |
| 1467629980 | Kristine Joy Distor | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762-3502 | 2008-05-14 |
| 1326215724 | Kenneth Edward Kopitzke | Military Health Care Provider | 15100 Rescue Way, Uscg Air Station Clearwater Clinic, Clearwater, FL 33762 | 2008-05-14 |
| 1184767006 | Amber Lynn Barrick | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-14 |
| 1326180308 | Vivian Linette Pares | Dental Hygienist | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-13 |
| 1265572986 | Teresa Davis | Military Health Care Provider | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-08 |
| 1659411700 | Angela Karcinski | Physician Assistant | 15100 Rescue Way, Us Coast Guard Airsta Clearwater, Clearwater, FL 33762-3502 | 2007-02-07 |
| 1306986393 | Uscg Personal Service Center | Health Maintenance Organization | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-07 |
| 1609950674 | Uscg Air Station Clearwater | Clinic/Center | 15100 Rescue Way, Clearwater, FL 33762 | 2006-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164051850 | Kimberly L Johnson | Home Health | 14055 46th Street North Suite 1102, Clearwater, FL 33762 | 2020-04-03 |
| 1134756869 | Pinellas County Sheriff's Office | Clinic/Center | Pinellas County Jail, 14400 49th Street North, Clearwater, FL 33762 | 2020-03-24 |
| 1285272815 | Gastro Florida Pharmacy, LLC | Pharmacy | 3001 Executive Drive, Suite 130, Clearwater, FL 33762 | 2019-12-13 |
| 1013401108 | Franz Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 4707 140th Ave N Ste 307, Clearwater, FL 33762 | 2018-06-21 |
| 1023502184 | Clearwater Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 4707 140th Ave N Ste 312, Clearwater, FL 33762 | 2018-06-21 |
| 1861803850 | Pinellas 1 Home Health Corp | Home Health | 4707 140th Avenue North Ste 106a, Clearwater, FL 33762 | 2014-05-13 |
| 1093065633 | Fast360 LLC | Transportation Broker | 10200 49th St N Ste 100, Clearwater, FL 33762 | 2012-09-11 |
| 1316253867 | Sophia Zavrou | Psychologist | 2325 Ulmerton Rd Ste 7g, Clearwater, FL 33762 | 2010-08-22 |
| 1356671275 | Suncoast Medicare Supply Company Inc. | Durable Medical Equipment & Medical Supplies | 4552b 107th Circle N, Clearwater, FL 33762 | 2009-12-29 |
| 1407006042 | Cynthia Rena' Williams | Physical Therapist | 13535 Feather Sound Dr., Suite 135, Clearwater, FL 33762 | 2008-09-19 |
| Find all providers in zip 33762 | ||||
| Taxonomy Code | 124Q00000X |
| Grouping | Dental Providers |
| Classification | Dental Hygienist |
| An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184706921 | Brandy Jo Jennings | Dental Hygienist | 1455 Sunset Point Road, Clearwater, FL 33755 | 2006-10-20 |
| 1326180308 | Vivian Linette Pares | Dental Hygienist | 15100 Rescue Way, Clearwater, FL 33762 | 2007-02-13 |
| 1437231271 | Narisa A Dachsangvorn | Dental Hygienist | 1455 Sunset Point Road, Clearwater, FL 33755 | 2006-10-20 |
| 1528048568 | Nancy Annette Konow | Dental Hygienist | 15100 Rescue Way, Clearwater, FL 33762-3524 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164037453 | Mary Kate Pace | Dental Hygienist | 1115 N Eglin Pkwy, Shalimar, FL 32579-1228 | 2020-09-13 |
| 1578173910 | Kimberly Beck | Dental Hygienist | 18030 Sandtrap Dr, Naples, FL 34114-7596 | 2020-07-31 |
| 1962012328 | Melody Jean Garcia | Dental Hygienist | Navy Medicene Support Command : Medical Staff Services, Bldg H, 2005 Knight Lane, Jacksonville, FL 32221-0140 | 2020-07-31 |
| 1043829385 | Mailyn Cortes | Dental Hygienist | 1134 Sw 12th Ct, Miami, FL 33135-5418 | 2020-07-22 |
| 1841817988 | Polly Ward | Dental Hygienist | 1022 Main St Ste P, Dunedin, FL 34698-5225 | 2020-07-04 |
| 1760007959 | Leanne Crist Nichol | Dental Hygienist | 6957 Boulder Run Loop, Wesley Chapel, FL 33545-4854 | 2020-06-12 |
| 1124641337 | Rhoda P Kublickis | Dental Hygienist | 274 Tropic Dr, Lauderdale By The Sea, FL 33308-5428 | 2020-05-21 |
| 1306468533 | Heather Paul | Dental Hygienist | 8839 Handel Loop, Land O Lakes, FL 34637 | 2020-05-11 |
| 1902426729 | Jose Dalby Contreras | Dental Hygienist | 690 Sw 1st Ct Apt 2319, Miami, FL 33130-2927 | 2020-04-22 |
| 1659991974 | Maggie Cruciata | Dental Hygienist | 974 International Pkwy, Lake Mary, FL 32746-5219 | 2020-04-17 |
| Find all providers with the same taxonomy | ||||
| City | CLEARWATER |
| Zip Code | 33762 |
Please comment or provide details below to improve the information on MRS. MARYELLEN TILLY.
| 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.