Timothy Ray Harbolt, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6816 Issued in OR

Practice address

1174 Molalla Ave
Oregon City, OR 97045-3770

Phone

(503) 646-6464

Fax

(503) 557-4677

NPI assigned

Sep 10, 2012

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1942550694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6789 NW METGE AVE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973219355",
            "telephone_number": "503-551-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 MOLALLA AVE",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970453770",
            "telephone_number": "503-646-6464",
            "fax_number": "503-557-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBOLT",
        "first_name": "TIMOTHY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth A Hand, LPC-ASSOCIATE, CADCI
• Dawn L Hanson, RN
• Lauren Hanson
• Shane R Hanzlik, M.D.
• Mitchell T Harbolt, DMD
• Hardcore Happy LLC
• Linda L Hardman
• Shannon Hardman
• Audra Lee Harley
• Ryan Shaun Harman, QMHA

• General Practice Dentistry in Oregon City, OR
• Providers in Oregon City, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.