Robert John Timothy, D.D.S.

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

145092-9921 Issued in UT

Practice address

215 S 4TH St
Montpelier, ID 83254-1591

Phone

(208) 847-0153

NPI assigned

Apr 25, 2006

Last updated

Dec 20, 2021By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, UT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rtimothy322515@direct.med.utah.edu

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.

• East Carolina University

  dba ECU Physicians

  • Family Medicine Physician
  • Greenville, NC
  • NPI 1972551919
  Medicare reassignment NPD
• University of Utah Dental Services

  dba Univ. of Utah Hosp. Plastic Surgery-Dental

  • Plastic and Reconstructive Surgery Physician
  • Salt Lake City, UT
  • NPI 1346633203
  Medicare reassignment NPD
• East Carolina University

  • Internal Medicine Physician
  • Greenville, NC
  • NPI 1043260474
  NPD
• East Carolina University

  dba East Carolina University School of Dental Medicine

  • Dentist
  • Greenville, NC
  • NPI 1669750014
  NPD
• University of Utah Dental Services

  dba University Hospital Dental Clinic

  • Dental Clinic/Center
  • Salt Lake City, UT
  • NPI 1447609631
  NPD
• University of Utah Dental Services

  dba University Hospital School of Dentistry

  • Dental Clinic/Center
  • Salt Lake City, UT
  • NPI 1821446279
  NPD
• Bear Lake Dental Care, PLLC

  • General Practice Dentistry
  • Montpelier, ID
  • NPI 1811001498
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1811953276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S 4TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541591",
            "telephone_number": "208-847-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S 4TH ST",
            "city": "MONTPELIER",
            "state": "ID",
            "postal_code": "832541591",
            "telephone_number": "208-847-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOTHY",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3060",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "UT",
            "license": "145092-9921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003303600",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtimothy322515@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Houston Reynolds, MD
• Anthony Stafford Ruud, PHARM-D
• Steven D. Hammond DDS PA
• Matthew Brinton Stevens, D.C.
• Doris Faye Thornock
• Shaun David Tobler, MSW, LCSW
• Valley Home Oxygen
• Dean A Wallentine, PHARM D.
• Kasey L Ward, NP
• Mina L Wayman, GNP

• Dentist in Montpelier, ID
• Providers in Montpelier, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.