Individual provider Active NPI

Timothy David Calkins, DDS

  • General Practice Dentistry
  • Lincoln, NE
National Provider Identifier
1336207638
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5637 Issued in NE
Practice address
4740 F Street
Lincoln, NE 68510-3730
Phone
(402) 488-1661
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 5637 NE Primary

Addresses

Primary practice location

4740 F Street
Lincoln, NE 68510-3730

Mailing address

4740 F Street
Lincoln, NE 68510-3730
Phone (402) 488-1661

Other identifiers 2

IdentifierTypeStateIssuer
05947OtherNEBCBSNE
47-0736447-00MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000105 NE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840430393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5637NEMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336207638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 F STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103730",
            "telephone_number": "402-488-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 F STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103730",
            "telephone_number": "402-488-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALKINS",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "5637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNE",
            "identifier": "05947",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-0736447-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.