Active NPI
Timothy Mark King, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Antonio, TX
National Provider Identifier
1033131362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 23939
- Practice address
- 17700 N US Highway 281
Suite 320
San Antonio, TX 78232-1404 - Phone
- (210) 495-6255
- Fax
- (210) 495-6260
- NPI assigned
- Jul 24, 2006
- Last updated
- Dec 22, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 23939 | TX | Primary |
Addresses
Primary practice location
17700 N US Highway 281
Suite 320
San Antonio, TX 78232-1404
Mailing address
17700 N US Highway 281
Suite 320
San Antonio, TX 78232-1404
Phone (210) 495-6255
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23939 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Dental Professionals San Antonio PC | Past | Accepting new patients |
Organizations & group practices 1
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": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324512000000",
"number": "1033131362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17700 N US HIGHWAY 281",
"address_2": "SUITE 320",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321404",
"telephone_number": "210-495-6255",
"fax_number": "210-495-6260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17700 N US HIGHWAY 281",
"address_2": "SUITE 320",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321404",
"telephone_number": "210-495-6255",
"fax_number": "210-495-6260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "TIMOTHY",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2011-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "23939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.