Provider Demographics
NPI:1770621203
Name:DON G. TIMPTON, D.D.S. & ASSOCIATES, PA
Entity type:Organization
Organization Name:DON G. TIMPTON, D.D.S. & ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:TIMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-540-2443
Mailing Address - Street 1:11535 CARMEL COMMONS BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5313
Mailing Address - Country:US
Mailing Address - Phone:704-540-2443
Mailing Address - Fax:704-540-2335
Practice Address - Street 1:11535 CARMEL COMMONS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5313
Practice Address - Country:US
Practice Address - Phone:704-540-2443
Practice Address - Fax:704-540-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902269Medicaid