Individual provider Active NPI

Timothy Scott Tobias, D.D.S.

  • Endodontics
  • San Bernardino, CA
National Provider Identifier
1235294711
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
29678 Issued in CA
Practice address
1849 Commercenter E
Suite a
San Bernardino, CA 92408-3427
Phone
(909) 884-4741
Fax
(909) 885-8244
NPI assigned
Dec 26, 2006
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
Endodontics 1223E0200X 29678 CA Primary

Addresses

Primary practice location

1849 Commercenter E
Suite a
San Bernardino, CA 92408-3427

Mailing address

1849 Commercenter E
Suite a
San Bernardino, CA 92408-3427
Phone (909) 884-4741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150710001838 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3072825587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29678CAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235294711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 COMMERCENTER E",
            "address_2": "SUITE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083427",
            "telephone_number": "909-884-4741",
            "fax_number": "909-885-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 COMMERCENTER E",
            "address_2": "SUITE A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083427",
            "telephone_number": "909-884-4741",
            "fax_number": "909-885-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "TIMOTHY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "29678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.