Todd Trevor Timko, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 17106 Issued in FL

Practice address

4400 Bayou Blvd
Suite #44a
Pensacola, FL 32503-2673

Phone

(850) 474-3854

Fax

(850) 476-8290

NPI assigned

Jun 12, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 30, 2015 through Dec 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241222400000",
    "number": "1194985275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE #44A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-474-3854",
            "fax_number": "850-476-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD",
            "address_2": "SUITE #44A",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032673",
            "telephone_number": "850-474-3854",
            "fax_number": "850-476-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMKO",
        "first_name": "TODD",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2009-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "018-001557",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 17106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Tilghman
• Carla Rose Tillery, MD
• Jeanne Rene' Tilley, NURSE PRACTITIONER
• Stephanie Flynn Tilley, DMD
• Michael Tillman, CRNA
• Colleen Timmons
• Troy Marion Tippett, M.D.
• Meagan Tipton, OD
• Matthew Tisdale
• Titan Hospitalist Group LLC

• Oral and Maxillofacial Surgery (Dentist) in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.