Organization Active NPI

J Timothy Doerner Dda PA

  • Dentist
  • Clearwater, FL
National Provider Identifier
1861946550
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
J TIMOTHY DOERNER DDA PA
Practice address
2763 State Road 580
Clearwater, FL 33761-3350
Phone
(727) 791-1099
NPI assigned
Aug 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
James DoernerNPI 1598945354
Title
Owner
Phone
(727) 791-1099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2763 State Road 580
Clearwater, FL 33761-3350

Mailing address

2763 State Road 580
Clearwater, FL 33761-3350
Phone (727) 791-1099

National Provider Directory

National Provider Directory

Locations

2763 State Road 580
Clearwater, FL 33761
Phone (727) 791-1099

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1861946550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2763 STATE ROAD 580",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613350",
            "telephone_number": "727-791-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2763 STATE ROAD 580",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337613350",
            "telephone_number": "727-791-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J TIMOTHY DOERNER DDA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "DOERNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-791-1099"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.