Timothy J Woller D.D.S. PC

Primary specialty

DentistTaxonomy code 122300000X

License

11957D Issued in AK

Legal business name

TIMOTHY J WOLLER D.D.S. PC

Practice address

3535 College Rd
Ste 205
Fairbanks, AK 99709-3710

Phone

(907) 479-6747

NPI assigned

Apr 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy John Woller, D.D.S.NPI 1356565659

Title

President

Phone

(907) 479-6747

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy John Woller, D.D.S.

  • General Practice Dentistry
  • Fairbanks, AK
  • NPI 1356565659
  NPD (past) Authorized official
• Jonathan P Woller, D.M.D.

  • Dentist
  • Fairbanks, AK
  • NPI 1144385659
  NPD (past)

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

{
    "created_epoch": "1176508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386869527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE RD",
            "address_2": "STE 205",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093710",
            "telephone_number": "907-479-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 COLLEGE RD",
            "address_2": "STE 205",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093710",
            "telephone_number": "907-479-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY J WOLLER D.D.S. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WOLLER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "907-479-6747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AK",
            "license": "11957D",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amond Tilley
• Erin R Tilly, RMT, LMT
• Tiffany Rae Timm, PTA
• Caroline Elizabeth Timmerman, MD
• Sean Michael Timmons, PA-C
• Timothy W Teslow, M.D., P.C.
• Chanika Tirogene
• Charlie Titus
• Cristina Titus
• Jay Titus

• Dentist in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Dentist in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.