Individual provider Active NPI

Timothy Ian Mulcahy, D.D.S.

  • General Practice Dentistry
  • Palo Alto, CA
National Provider Identifier
1275614844
Registry record updated Jul 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31838 Issued in CA
Practice address
1795 El Camino Road
#100
Palo Alto, CA 94306
Phone
(650) 328-1223
Fax
(650) 327-8903
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31838 CA Primary

Addresses

Primary practice location

1795 El Camino Road
#100
Palo Alto, CA 94306

Mailing address

1795 El Camino Road
#100
Palo Alto, CA 94306
Phone (650) 328-1223

Other identifiers 1

IdentifierTypeStateIssuer
31838OtherCALICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31838CAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1275614844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 EL CAMINO ROAD",
            "address_2": "#100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94306",
            "telephone_number": "650-328-1223",
            "fax_number": "650-327-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 EL CAMINO ROAD",
            "address_2": "#100",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "94306",
            "telephone_number": "650-328-1223",
            "fax_number": "650-327-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULCAHY",
        "first_name": "TIMOTHY",
        "middle_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "31838",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.