Active NPI
Tim Carney, DMD LTD
- General Practice Dentistry
- Brandon, MS
National Provider Identifier
1679788558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- MS 2258
- Practice address
- 100 Avalon CT
Suite a
Brandon, MS 39047-7672 - Phone
- (601) 992-3351
- Fax
- (601) 992-3350
- NPI assigned
- May 13, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | MS 2258 | MS | Primary |
Addresses
Primary practice location
100 Avalon CT
Suite a
Brandon, MS 39047-7672
Mailing address
100 Avalon CT
Suite a
Brandon, MS 39047-7672
Phone (601) 992-3351
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 |
|---|---|---|---|
| MS 2258 | MS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1679788558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 AVALON CT",
"address_2": "SUITE A",
"city": "BRANDON",
"state": "MS",
"postal_code": "390477672",
"telephone_number": "601-992-3351",
"fax_number": "601-992-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 AVALON CT",
"address_2": "SUITE A",
"city": "BRANDON",
"state": "MS",
"postal_code": "390477672",
"telephone_number": "601-992-3351",
"fax_number": "601-992-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNEY",
"first_name": "TIM",
"name_prefix": "Dr.",
"credential": "DMD LTD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-13",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "MS 2258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.