Provider Demographics
NPI:1760771919
Name:TIPPIT, NATHANIEL G III (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:G
Last Name:TIPPIT
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:9099 KATY FWY
Mailing Address - Street 2:STE. 140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1640
Mailing Address - Country:US
Mailing Address - Phone:713-465-1860
Mailing Address - Fax:713-932-0564
Practice Address - Street 1:9099 KATY FWY
Practice Address - Street 2:STE. 140
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1640
Practice Address - Country:US
Practice Address - Phone:713-465-1860
Practice Address - Fax:713-932-0564
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2014-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX238861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice