Timothy E Nelson DDS PS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

TIMOTHY E NELSON DDS PS

Practice address

855 11TH Ave
Suite B
Longview, WA 98632-2461

Phone

(360) 425-7220

Fax

(360) 425-5045

NPI assigned

Jul 1, 2006

Organization subpart

No

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

Authorized official

Name

Timothy E Nelson, DDS

Title

Corporation Officer

Phone

(360) 425-7220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1821027913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 11TH AVE",
            "address_2": "SUITE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322461",
            "telephone_number": "360-425-7220",
            "fax_number": "360-425-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 11TH AVE",
            "address_2": "SUITE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322461",
            "telephone_number": "360-425-7220",
            "fax_number": "360-425-5045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY E NELSON DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CORPORATION OFFICER",
        "authorized_official_telephone_number": "360-425-7220",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Longview, WA
• Providers in Longview, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.