Timothy E. Skidmore, D.D.S., P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019025894 Issued in IL

Legal business name

TIMOTHY E. SKIDMORE, D.D.S., P.C.

Practice address

39W250 Herrington Blvd
Suite F1
Geneva, IL 60134-6192

Phone

(630) 208-0051

NPI assigned

Jul 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Emerson Skidmore, D.D.S.NPI 1033109954

Title

President

Phone

(630) 208-0051

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mill Creek Dental Care Doing business as

Locations

Practitioners 1

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

• Timothy Emerson Skidmore, D.D.S

  • General Practice Dentistry
  • Geneva, IL
  • NPI 1033109954
  NPD (past) Authorized official

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1902061344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39W250 HERRINGTON BLVD",
            "address_2": "SUITE F1",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346192",
            "telephone_number": "630-208-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39W250 HERRINGTON BLVD",
            "address_2": "SUITE F1",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346192",
            "telephone_number": "630-208-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY E. SKIDMORE, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "EMERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-208-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019025894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189948",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Creek Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachael Thorson, DO
• Thrive Pediatrics, LLC
• Noah Throw
• Lisa Tierney, CRNA
• Time Out Therapy Service
• Mardi Anne Tingzon, DDS
• Colette A Titus, M.A. CCC-SLP
• Joelle Marie Tolentino, APRN, CNP
• Madeline Tomlinson
• Marianne Tomlinson, LCPC

• Dental Clinic/Center in Geneva, IL
• Providers in Geneva, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.