Active NPI
Timothy Dimitri Verny, D.D.S
- Dentist
- Hawthorne, CA
National Provider Identifier
1336125913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48778
- Practice address
- 13935 Hawthorne Blvd
Hawthorne, CA 90250-7001 - Phone
- (310) 973-6428
- Fax
- (310) 973-5395
- NPI assigned
- Dec 15, 2005
- Last updated
- Feb 13, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 48778 | CA | Primary |
| General Practice Dentistry | 1223G0001X | 48778 | CA |
Addresses
Primary practice location
13935 Hawthorne Blvd
Hawthorne, CA 90250-7001
Mailing address
13935 Hawthorne Blvd
Hawthorne, CA 90250-7001
Phone (310) 973-6428
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48778 | Other | CA | DENTICAL PROVIDER 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
| License | State | Type | Specialty |
|---|---|---|---|
| 48778 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Calabasas Center for Oral Surgery | Past | Accepting new patients | |
| Timothy D. Verny, DDS, Inc. | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Hawthorne Dental
- General Practice Dentistry
- Hawthorne, CA
- NPI 1417208067
-
- Oral and Maxillofacial Surgery (Dentist)
- Calabasas, CA
- NPI 1053552562
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360713600000",
"number": "1336125913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13935 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902507001",
"telephone_number": "310-973-6428",
"fax_number": "310-973-5395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13935 HAWTHORNE BLVD",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902507001",
"telephone_number": "310-973-6428",
"fax_number": "310-973-5395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERNY",
"first_name": "TIMOTHY",
"middle_name": "DIMITRI",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-15",
"last_updated": "2013-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48778",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "48778",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL PROVIDER NUMBER",
"identifier": "48778",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.