Timothy D. Tishler, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6623-015 Issued in WI

Practice address

2596 S. Bay Shore Dr.
Sister Bay, WI 54234

Phone

(920) 854-6556

Fax

(920) 854-6559

NPI assigned

Jun 27, 2005

Last updated

Mar 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1699771345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2596 S BAY SHORE DR",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "542349157",
            "telephone_number": "920-854-6556",
            "fax_number": "920-854-6559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2596 S. BAY SHORE DR.",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "54234",
            "telephone_number": "920-854-6556",
            "fax_number": "920-854-6559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISHLER",
        "first_name": "TIMOTHY",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-021598",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6623-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley Smith, PT
• Michael David Stubenvoll, PHARMD
• Holly Ann Swain, PA-C
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Scandia Village)
• James R Thomas, R.PH
• Deborah Marie Webber, DC
• Alison Werner, L.AC.
• C Thomas Wilson, DDS

• General Practice Dentistry in Sister Bay, WI
• Providers in Sister Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.