Timothy Bandrowsky, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

8089 Issued in CO

Practice address

755 S Perry St
Ste 300
Castle Rock, CO 80104-1901

Phone

(303) 660-5651

Fax

(303) 660-1582

NPI assigned

Jun 23, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Quantum LLC

  • Ambulatory Surgical Clinic/Center
  • Colorado Springs, CO
  • NPI 1306960943
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1366448417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 S PERRY ST",
            "address_2": "STE 300",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041901",
            "telephone_number": "303-660-5651",
            "fax_number": "303-660-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S PERRY ST",
            "address_2": "STE 300",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041901",
            "telephone_number": "303-660-5651",
            "fax_number": "303-660-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANDROWSKY",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "8089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58457721",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heidi Kathaleen Bailey, PA-C
• Melanie Marsh Bailey, LCSW
• Rebecca Lynn Baker, LAC
• Mia Sedalia Baldacci
• Kristina Balog, RN
• Banyan Castle Rock, LLC
• Banyan Castle Rock, LLC
• Banyan Castle Rock, LLC
• Banyan Castle Rock, LLC
• Candace Rae Barish, RBT

• Oral and Maxillofacial Surgery (Dentist) in Castle Rock, CO
• Providers in Castle Rock, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.