Active NPI
Timothy Richardson, DDS
- Pediatric Dentistry
- Eugene, OR
National Provider Identifier
1184855967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 9577
- Practice address
- 4122 Quest Dr
Eugene, OR 97402-8768 - Phone
- (541) 844-1667
- Fax
- (541) 505-8463
- NPI assigned
- Jul 28, 2009
- Last updated
- Apr 12, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 9577 | OR | Primary |
Addresses
Primary practice location
4122 Quest Dr
Eugene, OR 97402-8768
Mailing address
4122 Quest Dr
Eugene, OR 97402-8768
Phone (541) 844-1667
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9577 | OR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acorn Dentistry for Kids - Hillsboro, LLC | Past | Accepting new patients | |
| Acorn Dentistry for Kids - Keizer, LLC | Past | Accepting new patients | |
| Eugene Kids' Dentist, LLC | Pediatric Dentistry | Past | Accepting new patients |
| Oregon Family Orthodontics LLC | Past | Accepting new patients | |
| Acorn Dentistry for Kids - Corvallis, LLC | Past | Accepting new patients |
Organizations & group practices 5
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.
-
dba Acorn Dentistry For Kids - Corvallis
- Dental Clinic/Center
- Corvallis, OR
- NPI 1669960019
-
dba Acorn Dentistry For Kids - Hillsboro
- Dental Clinic/Center
- Hillsboro, OR
- NPI 1104314558
-
- Dental Clinic/Center
- Keizer, OR
- NPI 1134661606
-
- Pediatric Dentistry
- Eugene, OR
- NPI 1366738858
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Eugene, OR
- NPI 1467900241
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1184855967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4122 QUEST DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974028768",
"telephone_number": "541-844-1667",
"fax_number": "541-505-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4122 QUEST DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974028768",
"telephone_number": "541-844-1667",
"fax_number": "541-505-8463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-28",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "9577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.