CELINE JOYCE CORNELIUS TIMOTHIUS (NPI# 1073112512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073112512 |
Entity Type | Individual |
Full Name | CELINE JOYCE CORNELIUS TIMOTHIUS |
Practice Address |
1430 John Wesley Gilbert Dr Augusta GA 30912-0001 |
Practice Telephone | 5029369538 |
Mailing Telephone | 5029369538 |
Enumeration Date | 2020-10-24 |
Last Update Date | 2020-10-25 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
DNF000437 | GA | Dental Providers |
Street Address |
1430 JOHN WESLEY GILBERT DR |
City | AUGUSTA |
State | GA |
Zip Code | 30912-0001 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801811245 | Nancy Beth Young | Dentist | 1430 John Wesley Gilbert Dr, Gc-3088, Augusta, GA 30912-0001 | 2006-07-13 |
1326672437 | Luke Robert | Student in an Organized Health Care Education/Training Program | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2020-02-27 |
1982237533 | Jessica R Anderson | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0150 | 2020-02-21 |
1992295646 | Fucong Tian | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0004 | 2018-05-17 |
1588189435 | Mohammed Bindakhil | Oral Medicinist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-6030 | 2017-08-11 |
1669995593 | Scarlet Beatriz Charmelo Silva | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912 | 2017-07-23 |
1033645171 | Timothy Kim | Student in an Organized Health Care Education/Training Program | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2017-05-11 |
1407387590 | William Lopez | Student in an Organized Health Care Education/Training Program | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2017-03-21 |
1841733326 | Au Surgery Center | Clinic/Center | 1430 John Wesley Gilbert Dr, Gc1055, Augusta, GA 30912-0001 | 2016-12-01 |
1144671397 | Mira Ghaly | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2016-06-29 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
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Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801420146 | Scott Hansen Lowry | Dentist | 1430 John Wesley Drive, Augusta, GA 30912-0001 | 2020-02-25 |
1871948695 | Kyle Garrett | Dentist | 2704 W Terrace Dr, Augusta, GA 30909-3622 | 2016-04-29 |
1841507928 | Cristiano Susin | Dentist | 1120 15th St # Ad1430, Mcg School of Dentistry Dept Periodontics, Augusta, GA 30912-0004 | 2010-09-09 |
1699810366 | Christopher William Cutler | Dentist | 1120 15th St # Gc-1335, Ghsu-college of Dental Medicine, Augusta, GA 30912-0004 | 2007-02-21 |
1891846754 | David W. Perrry | Dentist | 231 Davis Rd, Augusta, GA 30907-2407 | 2007-01-16 |
1952465742 | Jeffrey Jerome Dent | Dentist | 1238 Augusta West Pkwy, Augusta, GA 30909-1854 | 2006-12-19 |
1891714135 | Mark A Brunner | Dentist | 1430 John Wesley Gilbert Dr., Gc-1333, Augusta, GA 30327-3007 | 2006-07-18 |
1417900929 | Philip J Hanes | Dentist | 1430 John Wesley Gilbert, Gc-1024, Augusta, GA 30912-1001 | 2006-05-18 |
1144671397 | Mira Ghaly | Dentist | 1430 John Wesley Gilbert Dr, Augusta, GA 30912-0001 | 2016-06-29 |
1356719322 | Andrew Kurialacherry | Dentist | 3456 Wrightsboro Rd, Augusta, GA 30909-2678 | 2015-09-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.