Tim Allen Needham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4536 Issued in AL

Practice address

585 Claud Rd
Eclectic, AL 36024-6318

Phone

(334) 541-4002

Fax

(334) 541-4021

NPI assigned

Oct 10, 2006

Last updated

May 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1255429197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240817",
            "city": "ECLECTIC",
            "state": "AL",
            "postal_code": "360240016",
            "telephone_number": "334-541-4002",
            "fax_number": "334-541-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 CLAUD RD",
            "city": "ECLECTIC",
            "state": "AL",
            "postal_code": "360246318",
            "telephone_number": "334-541-4002",
            "fax_number": "334-541-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "TIM",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "4536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF A",
            "identifier": "79554",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "801429",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Eclectic, AL
• Providers in Eclectic, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.