Timothy Ray Creech, DDS

Individual provider Active NPI General Practice Dentistry · Zebulon, NC

NPI 1043357031 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043357031
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6217 (NC)
Practice address
812 N Arendell Ave
Zebulon, NC 27597-2306
Phone
(919) 269-7411
Fax
(919) 269-7471
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160711000288 NC Order and Referring Only - Dentist
Practitioner - Dentist
4587956636

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6217NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy R. Creech, DDS General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6217 NC Yes

Addresses

Primary practice location

812 N Arendell Ave
Zebulon, NC 27597-2306

Mailing address

PO Box 100
Zebulon, NC 27597-0100
Phone (919) 269-7411

Other providers in Zebulon, NC

All providers in Zebulon, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.