Individual provider Active NPI

Timothy Hurley, D.D.S.

  • General Practice Dentistry
  • Redding, CA
National Provider Identifier
1023425204
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
057921-1 Issued in NY
Practice address
1035 Placer St
Redding, CA 96001-1125
Phone
(530) 246-5710
Fax
(530) 245-0863
NPI assigned
Jul 19, 2014
Last updated
Apr 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 057921-1 NY Primary

Addresses

Primary practice location

1035 Placer St
Redding, CA 96001-1125

Mailing address

1035 Placer St
Redding, CA 96001-1125
Phone (530) 246-5710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
057921-1NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523577600000",
    "number": "1023425204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011125",
            "telephone_number": "530-246-5710",
            "fax_number": "530-245-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PLACER ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011125",
            "telephone_number": "530-246-5710",
            "fax_number": "530-245-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLEY",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-19",
        "last_updated": "2018-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057921-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.