Provider Demographics
NPI:1346839776
Name:TIPTON DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:TIPTON DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-789-0202
Mailing Address - Street 1:303 S OSAGE AVE
Mailing Address - Street 2:
Mailing Address - City:TIPTON
Mailing Address - State:MO
Mailing Address - Zip Code:65081-8470
Mailing Address - Country:US
Mailing Address - Phone:660-433-5741
Mailing Address - Fax:
Practice Address - Street 1:303 S OSAGE AVE
Practice Address - Street 2:
Practice Address - City:TIPTON
Practice Address - State:MO
Practice Address - Zip Code:65081-8470
Practice Address - Country:US
Practice Address - Phone:660-433-5741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental