Individual provider Active NPI

Timothy Alan Adams, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Clermont, FL
National Provider Identifier
1891884367
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN18011 Issued in FL
Practice address
1000 East Ave
Clermont, FL 34711-2534
Phone
(352) 242-2100
Fax
(352) 242-2030
NPI assigned
Oct 12, 2006
Last updated
Jan 2, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN18011 FL Primary

Addresses

Primary practice location

1000 East Ave
Clermont, FL 34711-2534

Mailing address

1211 Shorecrest Cir
Clermont, FL 34711-2967
Phone (407) 319-2746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160314000975 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2062718380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1891884367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 SHORECREST CIR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112967",
            "telephone_number": "407-319-2746",
            "fax_number": "352-242-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EAST AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112534",
            "telephone_number": "352-242-2100",
            "fax_number": "352-242-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "TIMOTHY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN18011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.