Individual provider Active NPI

Timothy John Zellmer, DDS

  • General Practice Dentistry
  • Great Falls, MT
National Provider Identifier
1124143193
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2015MT Issued in MT
Practice address
1301 Twelfth Avenue South
Great Falls, MT 59406-6890
Phone
(406) 216-5273
Fax
(406) 216-5274
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 2015MT MT Primary

Addresses

Primary practice location

1301 Twelfth Avenue South
Great Falls, MT 59406-6890

Mailing address

PO Box 6890
1301 Twelfth Avenue South
Great Falls, MT 59406-6890
Phone (406) 216-5273

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
2015MTMTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124143193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6890",
            "address_2": "1301 TWELFTH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066890",
            "telephone_number": "406-216-5273",
            "fax_number": "406-216-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 TWELFTH AVENUE SOUTH",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594066890",
            "telephone_number": "406-216-5273",
            "fax_number": "406-216-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLMER",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2015MT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.