Individual provider Active NPI

Timothy Michael Cliney, D.D.S.

  • General Practice Dentistry
  • Lynnwood, WA
National Provider Identifier
1558341008
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5234 Issued in WA
Practice address
19019 36TH Ave W
#F
Lynnwood, WA 98036-5713
Phone
(425) 774-9446
NPI assigned
Jan 19, 2006
Last updated
Nov 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5234 WA Primary

Addresses

Primary practice location

19019 36TH Ave W
#F
Lynnwood, WA 98036-5713

Mailing address

12028 152ND PL SE
Snohomish, WA 98290-6803
Phone (425) 774-9446

Medicare participation

Medicare enrollment files
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 4, 2015 through May 4, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5234WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Whan Michael Cho, DDS, P.S. PastSince Apr 21, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1558341008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12028 152ND PL SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982906803",
            "telephone_number": "425-774-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19019 36TH AVE W",
            "address_2": "#F",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365713",
            "telephone_number": "425-774-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINEY",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "5234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.