Timothy Maurice Drake, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M-581 Issued in SD

Practice address

103 West 12TH Avenue
Mitchell, SD 57301-1311

Phone

(605) 996-9235

Fax

(605) 996-2080

NPI assigned

May 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730300344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WEST 12TH AVENUE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011311",
            "telephone_number": "605-996-9235",
            "fax_number": "605-996-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WEST 12TH AVENUE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011311",
            "telephone_number": "605-996-9235",
            "fax_number": "605-996-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "TIMOTHY",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M-581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Mitchell, SD
• Providers in Mitchell, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.