Active NPI
Full Care Dental PLLC
- General Practice Dentistry
- Missoula, MT
National Provider Identifier
1174653372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1744
- Legal business name
- FULL CARE DENTAL PLLC
- Practice address
- 690 SW Higgins Ave Ste E
Missoula, MT 59803-1433 - Phone
- (406) 543-3777
- Fax
- (406) 543-6205
- NPI assigned
- Mar 6, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Timothy M Lawhorn, D.D.S.
- Title
- Owner, Dentist
- Phone
- (406) 543-3777
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1744 | MT | Primary |
Addresses
Primary practice location
690 SW Higgins Ave Ste E
Missoula, MT 59803-1433
Mailing address
690 SW Higgins Ave Ste E
Missoula, MT 59803-1433
Phone (406) 543-3777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0110903 | Medicaid | MT | |
| 5512828 | Other | MT | CHIP |
National Provider Directory
National Provider DirectoryLocations
690 SW Higgins Ave
Ste E
Missoula, MT 59803
Phone (406) 532-2381
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Billings, MT
- NPI 1417034562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1174653372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "690 SW HIGGINS AVE STE E",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598031433",
"telephone_number": "406-543-3777",
"fax_number": "406-543-6205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "690 SW HIGGINS AVE STE E",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598031433",
"telephone_number": "406-543-3777",
"fax_number": "406-543-6205"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FULL CARE DENTAL PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-06",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LAWHORN",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER, DENTIST",
"authorized_official_telephone_number": "406-543-3777",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "1744",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0110903",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIP",
"identifier": "5512828",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.