Timothy Alan Betita, MD, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS101214 Issued in CA

Practice address

32241 Crown Valley Pkwy Ste 220
Dana Point, CA 92629-3310

Phone

(949) 240-2280

Fax

(949) 240-2619

NPI assigned

May 31, 2011

Last updated

Apr 16, 2019By 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 5

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 Jul 1, 2017 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Betita Baker Dental Partnership

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Dana Point, CA
  • NPI 1962068478
  Authorized official Same address or phone
• Greater Modesto Dental Implant &Oral Surgery Center

  • Oral and Maxillofacial Surgery (Dentist)
  • Modesto, CA
  • NPI 1326468752
  NPD (past)

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1265726897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32241 CROWN VALLEY PKWY STE 220",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293310",
            "telephone_number": "949-240-2280",
            "fax_number": "949-220-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32241 CROWN VALLEY PKWY STE 220",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926293310",
            "telephone_number": "949-240-2280",
            "fax_number": "949-240-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETITA",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD, DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "30090",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "9811800-9921",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "A151709",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DENT.DE.60660678",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS101214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew R Beck, LMFT
• Bee-Have LLC
• Sayeh Beheshti, M.D.
• Kristin Marie Beierle, DC
• Betita Baker Dental Partnership
• Betterbio Synthesis
• Bewell Orange County LLC (Sheer Recovery LLC)
• Alisa Marie Beyer
• Maya B Bidichandani-Kaura, MD
• Wade Mattson Binley, DC

• Oral and Maxillofacial Surgery (Dentist) in Dana Point, CA
• Providers in Dana Point, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.