Individual provider Active NPI

John Timothy Seely Jr., DDS

  • Dentist
  • Savannah, GA
National Provider Identifier
1104340025
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012730A Issued in IN
Practice address
230 Casablanca Dr BLDG 1445
Savannah, GA 31409-5107
Phone
(571) 801-7148
NPI assigned
Aug 2, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12012730A IN Primary

Addresses

Primary practice location

230 Casablanca Dr BLDG 1445
Savannah, GA 31409-5107

Mailing address

230 Casablanca Dr BLDG 1445
Savannah, GA 31409-5107
Phone (571) 801-7148

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

LicenseStateTypeSpecialty
12012730AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
HQ US Army Dental Activities Dentist PastSince Jul 1, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1104340025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CASABLANCA DR BLDG 1445",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "571-801-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CASABLANCA DR BLDG 1445",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314095107",
            "telephone_number": "571-801-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEELY",
        "first_name": "JOHN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-02",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012730A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.