Individual provider Active NPI

Timothy Morris, DDS

  • General Practice Dentistry
  • Merritt Island, FL
National Provider Identifier
1003827569
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN14096 Issued in FL
Practice address
775 E Merritt Island Cswy
Suite 115
Merritt Island, FL 32952-3311
Phone
(321) 729-0004
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN14096 FL Primary

Addresses

Primary practice location

775 E Merritt Island Cswy
Suite 115
Merritt Island, FL 32952-3311

Mailing address

1694 W Hibiscus Blvd
Suite a
Melbourne, FL 32901-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160212001934 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9133423007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CDPG, P.L. General Practice PastSince Jan 17, 2022 Accepting new patients
CDPG, P.L. General Practice PastSince Jan 17, 2022 Accepting new patients
Christie Dental Practice Group General Practice Past Accepting new patients
CDPG, P.L. General Practice PastSince Jan 17, 2022 Accepting new patients

Networks

  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • FL HMO D-SNP
  • FL HMO C-SNP

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003827569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 W HIBISCUS BLVD",
            "address_2": "SUITE A",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 E MERRITT ISLAND CSWY",
            "address_2": "SUITE 115",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523311",
            "telephone_number": "321-729-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "TIMOTHY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN14096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.