Active NPI
Timothy Richard Garofolo, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1801934153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50912
- Practice address
- 11968 Bernardo Plaza Dr
San Diego, CA 92128-2538 - Phone
- (858) 451-2555
- Fax
- (858) 451-2845
- NPI assigned
- Feb 1, 2007
- Last updated
- Jul 8, 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 50912 | CA | Primary |
Addresses
Primary practice location
11968 Bernardo Plaza Dr
San Diego, CA 92128-2538
Mailing address
11968 Bernardo Plaza Dr
San Diego, CA 92128-2538
Phone (858) 451-2555
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50912 | CA | MD | Marriage & Family Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801934153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11968 BERNARDO PLAZA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282538",
"telephone_number": "858-451-2555",
"fax_number": "858-451-2845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11968 BERNARDO PLAZA DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282538",
"telephone_number": "858-451-2555",
"fax_number": "858-451-2845"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAROFOLO",
"first_name": "TIMOTHY",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "50912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- 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.