Individual provider Active NPI

Charles Timothy Lipp, DMD

  • General Practice Dentistry
  • Beaver Falls, PA
National Provider Identifier
1104809086
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS025760L Issued in PA
Practice address
3315 4TH Ave
Beaver Falls, PA 15010
Phone
(724) 843-7088
Fax
(724) 843-7088
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS025760L PA Primary

Addresses

Primary practice location

3315 4TH Ave
Beaver Falls, PA 15010

Mailing address

800 Fern Ave
Beaver Falls, PA 15010
Phone (724) 846-9690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160120000550 PA Order and Referring Only - DentistPractitioner - Dentist 2466755822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS025760LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104809086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FERN AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "15010",
            "telephone_number": "724-846-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 4TH AVE",
            "city": "BEAVER FALLS",
            "state": "PA",
            "postal_code": "15010",
            "telephone_number": "724-843-7088",
            "fax_number": "724-843-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPP",
        "first_name": "CHARLES",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS025760L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Falls, PA

Sources for this page

Verify at the official NPI Registry.