Timothy Emerson Skidmore, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019025894 Issued in IL

Practice address

39W250 Herrington Blvd Ste F1
Geneva, IL 60134

Phone

(630) 208-0051

NPI assigned

Oct 22, 2005

Last updated

Jun 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Timothy E. Skidmore, D.D.S., P.C.

  dba Mill Creek Dental Care

  • Dental Clinic/Center
  • Geneva, IL
  • NPI 1902061344
  NPD (past) Authorized official

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

{
    "created_epoch": "1129939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1033109954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606104032",
            "telephone_number": "815-399-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39W250 HERRINGTON BLVD STE F1",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "60134",
            "telephone_number": "630-208-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "TIMOTHY",
        "middle_name": "EMERSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-22",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sight to See Eyecare & Eyewear, PLLC
• Jonathan Silva, MSW
• Ronald J Simone, MD
• Stacy Sims, PHARMD
• Rajvinder Singh, MD
• Christine Anne Skinner, LCPC
• Lyle Skinner, PSYD, LCP
• Thomas Edward Skoumal, DDS
• Jacques Marc Slaiher, LCPC
• Nicholas Patrick Slattery, MD

• General Practice Dentistry in Geneva, IL
• Providers in Geneva, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.