Timothy John Isaacson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11656 Issued in MN

Practice address

4200 W Old Shakopee Rd
Suite 223
Bloomington, MN 55437-2976

Phone

(952) 881-8404

Fax

(952) 881-9520

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

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 Dec 8, 2010 through Dec 8, 2026

Medicare enrollment (NPD)

Not 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.

• Isaacson Dental Center PLLC

  • Dental Clinic/Center
  • Bloomington, MN
  • NPI 1871172726
  NPD Authorized official
• Anne C Adamson DDS LLC

  • General Practice Dentistry
  • Homer, AK
  • NPI 1164012092
  NPD (past)
• Homer Dental Center Inc

  • Dentist
  • Homer, AK
  • NPI 1962778001
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1396817482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5270 W 84TH ST STE 360",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371377",
            "telephone_number": "161-224-9688",
            "fax_number": "952-881-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W OLD SHAKOPEE RD",
            "address_2": "SUITE 223",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554372976",
            "telephone_number": "952-881-8404",
            "fax_number": "952-881-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACSON",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Expressions in Psychology, LLC
• International Maternal Care Initiative
• Ikram Mohammad Irfanullah, MD
• Isaacson Dental Center PLLC
• Dana John Isaacson, D.D.S.
• Isaiah Residential Care Services LLC
• Dorothee M Ischler, DMFT, LMFT
• Viktoriya A. Ishchuk, DDS
• Naseeb Mohammed Ismaiel
• Ismail Omar Ismail

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, 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 21, 2021; 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.