Timothy Quoc Tien, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57926 Issued in CA

Practice address

3531 El Cajon Blvd Ste a
San Diego, CA 92104-1512

Phone

(619) 584-8975

Fax

(619) 584-0682

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Timothy Tien DDS PC

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1275837171
  NPD (past) Authorized official
• Boulevard Dental Center

  • Dental Clinic/Center
  • San Diego, CA
  • NPI 1780728436
  NPD (past)

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1578629283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041512",
            "telephone_number": "619-584-8975",
            "fax_number": "619-584-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921041512",
            "telephone_number": "619-584-8975",
            "fax_number": "619-584-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEN",
        "first_name": "TIMOTHY",
        "middle_name": "QUOC",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5945",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS ID #",
            "identifier": "825739",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Francis Tidmarsh, M.D.
• Sarina Renae Tidwell
• Alexandria Nikole Tiedtke
• Katie Tiemeyer, M.A. CCC-SLP
• Tien Phan Psychologist, PC
• Renee Anderson Tietsworth, LCSW
• Katherine Marie Tietz, OTR/L
• Andy Liang Tieu, DDS
• Tiffany Neimar DDS Inc.
• Tiffany Pham MD, PC

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.