KIIRI TAMM TIETJENS (NPI# 1659435253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659435253 |
| Entity Type | Individual |
| Full Name | KIIRI TAMM TIETJENS |
| Credential | DDS |
| Practice Address |
750 Almar Pkwy Suite 102 Bourbonnais IL 60914-2315 |
| Practice Telephone | 8159397136 |
| Practice Fax Number | 8159399820 |
| Mailing Telephone | 8159397136 |
| Mailing Fax Number | 8159399820 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
IL | Dental Providers |
| Street Address |
750 ALMAR PKWY SUITE 102 |
| City | BOURBONNAIS |
| State | IL |
| Zip Code | 60914-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194885137 | United Surgical Assistants, Inc | Specialist/Technologist, Other | 750 Almar Pkwy, Suite 205, Bourbonnais, IL 60914-2315 | 2006-12-11 |
| 1780120584 | Megan J. Campbell, Art Therapy Inc. | Counselor | 750 Almar Pkwy, Suite 205, Bourbonnais, IL 60914-2315 | 2017-01-17 |
| 1972953099 | Amy Wiley Ma Lcpc P.C. | Counselor | 750 Almar Pkwy, Suite 205, Bourbonnais, IL 60914-2315 | 2016-06-20 |
| 1912378944 | Jon Dodds Phd Lcpc Ltd | Counselor | 750 Almar Pkwy, Suite 202, Bourbonnais, IL 60914-2315 | 2015-10-16 |
| 1649649575 | Margaret M. Brent | Counselor | 750 Almar Pkwy, Ste 205, Bourbonnais, IL 60914-2399 | 2015-09-22 |
| 1275973406 | Natural Health Remedies, LLC | Nursing Care | 750 Almar Pkwy, Suite 200, Bourbonnais, IL 60914-2315 | 2013-07-02 |
| 1114225141 | Frederick P Waldschmidt | Dentist | 750 Almar Pkwy, Suite 101, Bourbonnais, IL 60914-2315 | 2011-02-28 |
| 1043490733 | Justin Michael Steullet | Specialist/Technologist, Other | 750 Almar Pkwy, Suite 205, Bourbonnais, IL 60914-2315 | 2007-11-09 |
| 1659569630 | Laura E. Deyoung | Counselor | 750 Almar Pkwy, Bourbonnais, IL 60914-2315 | 2007-10-04 |
| 1659586477 | Mensa Kamaugogo Muata | Specialist/Technologist, Other | 750 Almar Pkwy, Suite 205, Bourbonnais, IL 60914-2315 | 2007-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648023 | Jacob Daniel Ledesma | Physical Therapist | 588 William R Latham Senior Dr Ste 5, Bourbonnais, IL 60914 | 2020-10-30 |
| 1467069823 | Alicia Nicole Kendra | Nurse Practitioner | Upliftedcare, 482 Main St. Nw, Bourbonnais, IL 60914 | 2020-09-29 |
| 1043860877 | Victor Manuel Vazquez Cervantes | Pharmacist | 2080 No, Il-50, Bourbonnais, IL 60914 | 2019-09-13 |
| 1740843267 | Panoptic Physical Therapy LLC | Physical Medicine & Rehabilitation | 1511 N. Convent St Suite 1000, Bourbonnais, IL 60914 | 2019-04-19 |
| 1770074577 | Colin P Koerner | Physical Therapist | 215 N Convent St Ste 6, Bourbonnais, IL 60914 | 2018-05-29 |
| 1306337340 | Megan Hoskins | Behavior Technician | 3187 N 2420 W Rd., Bourbonnais, IL 60914 | 2018-05-25 |
| 1932600459 | Thomas H George Dds PC | Clinic/Center | 14 Briarcliff Professional Center, Bourbonnais, IL 60914 | 2018-02-21 |
| 1780193904 | Kathleen M Saindon II | Speech-Language Pathologist | 1021 Deer Trail, Bourbonnais, IL 60914 | 2017-09-20 |
| 1457870206 | Janet Mary Notton | Speech-Language Pathologist | 920 W Margaret Lane, Bourbonnais, IL 60914 | 2017-09-13 |
| 1134646375 | Sagar Batish | Student in an Organized Health Care Education/Training Program | 1096 Country Lane, Bourbonnais, IL 60914 | 2017-08-28 |
| Find all providers in zip 60914 | ||||
| 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 |
|---|---|---|---|---|
| 1851389597 | Christopher Thomas Powell | Dentist | 31 Briarcliff Prof Ctr, Bourbonnais, IL 60914-1775 | 2005-10-06 |
| 1891843637 | Drs. Slaby, Adams and Tietjens, Ltd. | Dentist | 750 Almar Pkwy, Suite 102, Bourbonnais, IL 60914-2315 | 2007-01-08 |
| 1821146671 | Edward Irwin Slaby | Dentist | 750 Almar Pkwy, Suite 102, Bourbonnais, IL 60914-2315 | 2007-01-08 |
| 1225192826 | James Matthew Adams | Dentist | 750 Almar Pkwy, Suite 102, Bourbonnais, IL 60914-2315 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
| City | BOURBONNAIS |
| Zip Code | 60914 |
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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.