Individual provider Active NPI

Timothy Edward Jankowski, DDS

  • Dentist
  • McConnell AFB, KS
National Provider Identifier
1174848204
Registry record updated Jul 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60647 Issued in KS
Practice address
57950 Leavenworth St
McConnell AFB, KS 67221-3506
Phone
(785) 738-8356
NPI assigned
Mar 31, 2010
Last updated
Jul 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60647 KS Primary

Addresses

Primary practice location

57950 Leavenworth St
McConnell AFB, KS 67221-3506

Mailing address

PO Box 505
Beloit, KS 67420-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20150602001286 KS Order and Referring Only - DentistPractitioner - Dentist 3072834126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Designs of Solomon Valley, P.a. Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1174848204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "BELOIT",
            "state": "KS",
            "postal_code": "674200505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57950 LEAVENWORTH ST",
            "city": "MCCONNELL AFB",
            "state": "KS",
            "postal_code": "672213506",
            "telephone_number": "785-738-8356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKOWSKI",
        "first_name": "TIMOTHY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-31",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KS",
            "license": "60647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McConnell AFB, KS

Sources for this page

Verify at the official NPI Registry.