Active NPI
Timothy John Swanson, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Mankato, MN
National Provider Identifier
1699730366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S9
- Practice address
- 120 E Main St
Mankato, MN 56001-3501 - Phone
- (507) 388-2989
- Fax
- (507) 388-2985
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 44784 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | S9 | MN | Primary |
Addresses
Primary practice location
120 E Main St
Mankato, MN 56001-3501
Mailing address
120 E Main St
Mankato, MN 56001-3501
Phone (507) 388-2989
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 |
|---|---|---|---|
| 44784 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| S9 | MN | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199923200000",
"number": "1699730366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E MAIN ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560013501",
"telephone_number": "507-388-2989",
"fax_number": "507-388-2985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E MAIN ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560013501",
"telephone_number": "507-388-2989",
"fax_number": "507-388-2985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "TIMOTHY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2008-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "44784",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MN",
"license": "S9",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.