Timothy Shelburne Smith, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

23792 Issued in CA

Practice address

2878 Camino del Rio S
Suite 210
San Diego, CA 92108-3872

Phone

(619) 298-2200

Fax

(619) 298-2250

NPI assigned

Nov 22, 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 May 20, 2024 through May 20, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tsmith80490@scrippshlth.medalliesdirect.net

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.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487729554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S",
            "address_2": "SUITE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083872",
            "telephone_number": "619-298-2200",
            "fax_number": "619-298-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 CAMINO DEL RIO S",
            "address_2": "SUITE 210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083872",
            "telephone_number": "619-298-2200",
            "fax_number": "619-298-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "SHELBURNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "23792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Marie Smith
• Teresa L Smith, PH.D
• Theresa Smith
• Thomas Smith
• Tiffany Chenlle Smith
• Trevor Paul Smith, PA
• Tukisa D Smith, MD
• Tyler Smith
• Vincent R Smith, OTRL
• Wayne Christopher Smith, R.N.

• Oral and Maxillofacial Surgery (Dentist) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.