Clinton Scott Timmerman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00010745 Issued in CO

Practice address

410 Macon Ave
Canon City, CO 81212-3225

Phone

(719) 276-0117

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Cascade Medical and Dental LLC

  • Dental Clinic/Center
  • Canon City, CO
  • NPI 1689195836
  NPD Authorized official
• Clinton Scott Timmerman PLLC

  • Dental Clinic/Center
  • Marysville, WA
  • NPI 1528752474
  NPD Authorized official
• Clinton Timmerman, DDS, PLLC

  • Dental Clinic/Center
  • Snohomish, WA
  • NPI 1659178465
  NPD Authorized official
• Heritage Creek Dental LLC

  • Dentist
  • Clive, IA
  • NPI 1033438957
  NPD (past) Authorized official

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1598958548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S DOGWOOD CT",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810077564",
            "telephone_number": "206-818-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123225",
            "telephone_number": "719-276-0117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 S Dogwood Ct",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810077564",
            "country_code": "US",
            "telephone_number": "206-818-0769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMERMAN",
        "first_name": "CLINTON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57971",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60046233",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08515",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00010745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Thornton, OTR
• Bradley Darin Thorsen, MS, LPCC
• Alisabeth A. Thurston-Hicks, M.D.
• Angela Lynn Tidemann, FNP
• Time for Me, LLC
• Timothy R Brown MD
• TLC Traveling Smiles
• Robert E Tonsing, M.D.
• Trailhead Thearpy Collective LLC
• Stephanie Traub, MA, LPC, NCC

• General Practice Dentistry in Canon City, CO
• Providers in Canon City, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.