Individual provider Active NPI

Timothy Entwistle, DDS

  • General Practice Dentistry
  • Rochester, NY
National Provider Identifier
1346273109
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
051731 Issued in NY
Practice address
2655 Ridgeway Ave
Suite 360
Rochester, NY 14626-4296
Phone
(585) 295-1890
Fax
(585) 295-1898
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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 051731 NY Primary

Addresses

Primary practice location

2655 Ridgeway Ave
Suite 360
Rochester, NY 14626-4296

Mailing address

2655 Ridgeway Ave
Suite 360
Rochester, NY 14626-4296
Phone (585) 295-1890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240319000458 NY Practitioner - Dentist 5496059990 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
051731NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clifton Springs Sanitarium Co CurrentSince Feb 9, 2024 Accepting new patients
The Unity Hospital of Rochester CurrentSince Feb 9, 2024 Accepting new patients
Western New York Medical Practice P.C CurrentSince Feb 9, 2024 Accepting new patients
Western New York Medical Practice P.C. CurrentSince Feb 9, 2024 Accepting new patients
Rochester General Hospital General Practice CurrentSince Feb 9, 2024 Accepting new patients
The Unity Hospital of Rochester Current Accepting new patients
Rochester General Hospital CurrentSince Feb 9, 2024 Accepting new patients
The Unity Hospital of Rochester Past Accepting new patients

Locations

2 Coulter Rd
Clifton Springs, NY 14432
Phone (315) 462-1472

2655 Ridgeway Ave
Ste 360
Rochester, NY 14626
Phone (585) 295-1890

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Interoperability endpoints

  • Direct secure messaging: tentwistle211251@direct.rochesterregional.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1346273109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 360",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-295-1890",
            "fax_number": "585-295-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 RIDGEWAY AVE",
            "address_2": "SUITE 360",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146264296",
            "telephone_number": "585-295-1890",
            "fax_number": "585-295-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTWISTLE",
        "first_name": "TIMOTHY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.