Timothy Robert Jessop, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4308 Issued in ID

Practice address

465 Memorial Dr
Pocatello, ID 83201-4008

Phone

(208) 282-6000

NPI assigned

Jul 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1245542596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2688 VIA VALDARNO",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014008",
            "telephone_number": "208-282-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSOP",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy John Jenkins, DPT
• Charles William Jenks
• Jennifer Miesch PHD
• Eric Jensen, MD
• Jamee Lee Jensen
• Kristen Jex, LPC
• Jared Jockumsen, LSW
• Joe'S Shuttle Service
• Arpun Kaur Johal, DDS
• Nikki K Johansen

• General Practice Dentistry in Pocatello, ID
• Providers in Pocatello, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.