Timothy Joseph Pranger, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

4119 Humbert Rd
Alton, IL 62002-7116

Phone

(618) 465-8100

NPI assigned

Jan 2, 2007

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

Enrolled in IL

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Humbert Road Dentistry

  • Dentist
  • Alton, IL
  • NPI 1942501911
  NPD (past)
• Moody Hanahan Dentistry LLC

  dba Humbert Road Dentistry

  • Dental Clinic/Center
  • Alton, IL
  • NPI 1528693926
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831256817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N MAIN ST",
            "city": "CARROLLTON",
            "state": "IL",
            "postal_code": "620161002",
            "telephone_number": "217-248-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 HUMBERT RD",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027116",
            "telephone_number": "618-465-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANGER",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Potillo
• Jenna Potter, MA,LPC
• Patricia L Potter, LCPC
• Christopher W Pottmeyer, M.D.
• Practical Rehab Services, LTD.
• Carla Price Lybarger
• Carmen Price, MA
• Casey Price, MA
• Principia Health & Wellness Pharmacy Inc (Shields Family Pharmacy)
• Private Home Care of Illinois LLC

• General Practice Dentistry in Alton, IL
• Providers in Alton, IL by specialty
• General Practice Dentistry in Illinois

• 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.
• 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.