Timothy J McMahon, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4988 Issued in KY

Practice address

300 Arbors Drive
Suite 5
Dry Ridge, KY 41035

Phone

(859) 823-0111

Fax

(859) 823-9111

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1003907015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ARBORS DRIVE",
            "address_2": "SUITE 5",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "41035",
            "telephone_number": "859-823-0111",
            "fax_number": "859-823-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ARBORS DRIVE",
            "address_2": "SUITE 5",
            "city": "DRY RIDGE",
            "state": "KY",
            "postal_code": "41035",
            "telephone_number": "859-823-0111",
            "fax_number": "859-823-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "KY",
            "license": "4988",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60049889",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jody Elaine Keeley
• Livewell Gastroenterology, PLLC
• Gina Lowe, LDO
• Zoe Luebbe, DPT
• Nicholas Ryan Mairose, LDO
• Brian Melton, APRN
• MFDC of Ky LLC
• Hunter Mitchell, DMD
• Amanda Lerae Naranjo, PHARMD
• Suzanne Renee Noel, M.S., OTR/L

• General Practice Dentistry in Dry Ridge, KY
• Providers in Dry Ridge, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.