Scott David Timmons, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11404 Issued in MN

Practice address

13442 Elmwood Dr
Baxter, MN 56425-8400

Phone

(218) 829-4207

Fax

(218) 829-4160

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Baxter Dental

  • Dental Clinic/Center
  • Baxter, MN
  • NPI 1245840487
  NPD Authorized official
• Baxter Dental PLLC

  • Dental Clinic/Center
  • Baxter, MN
  • NPI 1790415842
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1356486997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13442 ELMWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258400",
            "telephone_number": "218-829-4207",
            "fax_number": "651-351-2948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13442 ELMWOOD DR",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258400",
            "telephone_number": "218-829-4207",
            "fax_number": "218-829-4160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "SCOTT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Amazing Journey, Inc
• The Amazing Journey, LLC
• Ronnie Mae Theis
• Alyssa Thesing
• Hannah Thiry, MD
• Shannon Michelle Torborg, PSY.D., L.P.
• Tran-Lunning Dental PLLC
• Traveling Light Psychiatric Services
• Alexis Rae Trebesch
• Jaydan Marie Trnka

• General Practice Dentistry in Baxter, MN
• Providers in Baxter, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.