Timothy J Casey, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

9028 Issued in WA

Practice address

22011 E Country Vista Dr Ste 201
Liberty Lake, WA 99019-5242

Phone

(509) 927-9279

Fax

(509) 927-9278

NPI assigned

Oct 24, 2006

Last updated

Dec 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Shadle Smile Source PLLC

  • Dental Clinic/Center
  • Spokane, WA
  • NPI 1154083822
  NPD Authorized official
• Casey Family Dental DDS, PS

  dba Liberty Lake Smile Source

  • Dentist
  • Liberty Lake, WA
  • NPI 1568926046
  NPD
• Down River Smiles

  • Dental Clinic/Center
  • Spokane, WA
  • NPI 1205593084
  NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1942383534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22910 E APPLEWAY",
            "address_2": "#5",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "99019",
            "telephone_number": "509-927-9279",
            "fax_number": "509-927-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22011 E COUNTRY VISTA DR STE 201",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990195242",
            "telephone_number": "509-927-9279",
            "fax_number": "509-927-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "9028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5036710",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cathi Denee Cardon, OT
• Elizabeth Joy Carlson, BA
• Jazmayne Carter
• Casey Family Dental DDS, PS (Liberty Lake Smile Source)
• Michael Francis Casey
• Christie Ann Ceballos, PA-C
• Svetlana Cervantes, MSW
• Christy Lynn Chamberlain
• Daniel S Chamberlain, DC
• Heidi Laura Evans Christensen, NAC AND HCA

• Dentist in Liberty Lake, WA
• Providers in Liberty Lake, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.