Active NPI
Timothy J Killgrove, DDS
- Dentist
- Novi, MI
National Provider Identifier
1285724617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 16367
- Practice address
- 39525 West 14 Mile Road
Suite 201
Novi, MI 48377-1638 - Phone
- (248) 624-2951
- Fax
- (248) 624-4741
- NPI assigned
- Oct 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 16367 | MI | Primary |
Addresses
Primary practice location
39525 West 14 Mile Road
Suite 201
Novi, MI 48377-1638
Mailing address
39525 West 14 Mile Road
Suite 201
Novi, MI 48377-1638
Phone (248) 624-2951
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16367 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285724617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39525 WEST 14 MILE ROAD",
"address_2": "SUITE 201",
"city": "NOVI",
"state": "MI",
"postal_code": "483771638",
"telephone_number": "248-624-2951",
"fax_number": "248-624-4741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39525 WEST 14 MILE ROAD",
"address_2": "SUITE 201",
"city": "NOVI",
"state": "MI",
"postal_code": "483771638",
"telephone_number": "248-624-2951",
"fax_number": "248-624-4741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLGROVE",
"first_name": "TIMOTHY",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "16367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.