Active NPI
Timothy Patrick Labrosse, D.D.S.
- General Practice Dentistry
- Coeur D Alene, ID
National Provider Identifier
1497784508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-2000
- Practice address
- 700 W Ironwood Dr
Suite 212
Coeur D Alene, ID 83814-2656 - Phone
- (208) 664-4831
- Fax
- (208) 666-1804
- NPI assigned
- Jul 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-2000 | ID | Primary |
| General Practice Dentistry | 1223G0001X | 6424 | WA |
Addresses
Primary practice location
700 W Ironwood Dr
Suite 212
Coeur D Alene, ID 83814-2656
Mailing address
700 W Ironwood Dr
Suite 212
Coeur D Alene, ID 83814-2656
Phone (208) 664-4831
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-2000 | ID | MD | General Practice Dentistry |
| 6424 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1497784508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 W IRONWOOD DR",
"address_2": "SUITE 212",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142656",
"telephone_number": "208-664-4831",
"fax_number": "208-666-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 W IRONWOOD DR",
"address_2": "SUITE 212",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142656",
"telephone_number": "208-664-4831",
"fax_number": "208-666-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABROSSE",
"first_name": "TIMOTHY",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-2000",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "6424",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.