Timothy Michael Poyadou Jr., B.S., D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6377 Issued in LA

Practice address

100 Tyler SQ Ste 4
Covington, LA 70433-3060

Phone

(985) 266-2000

Fax

(985) 266-2002

NPI assigned

Apr 5, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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.

• Covington Empower Orthodontics LLC - Dr Timothy M Poyadou Jr

  • Dental Clinic/Center
  • Covington, LA
  • NPI 1851912711
  NPD Authorized official
• Mandeville Dental Associates LLC

  • Pediatric Dentistry
  • Mandeville, LA
  • NPI 1013770189
  NPD Authorized official
• Covington Empower Orthodontics LLC - Dr Timothy M Poyadou Jr

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Denham Springs, LA
  • NPI 1528945128
  NPD

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1366785602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 TYLER SQ STE 4",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333060",
            "telephone_number": "985-266-2000",
            "fax_number": "985-266-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TYLER SQ STE 4",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333060",
            "telephone_number": "985-266-2000",
            "fax_number": "985-266-2002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4521 Atlantic Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322072165",
            "country_code": "US",
            "telephone_number": "904-398-8970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POYADOU",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "B.S., D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-05",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19309",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN19309",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "LA",
            "license": "6377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preference Medical
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• Orthodontics and Dentofacial Orthopedics Dentistry in Covington, LA
• Providers in Covington, LA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.