DR. TIMOTHY WALTER PENBERTHY (NPI# 1285786194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285786194 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY WALTER PENBERTHY |
| Credential | D.D.S. |
| Practice Address |
509 W Hanley Ave Suite # 2 Coeur D Alene ID 83815-8994 |
| Practice Telephone | 2086648622 |
| Mailing Telephone | 2086648622 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D-1930-EN | ID | Dental Providers |
| Street Address |
509 W HANLEY AVE SUITE # 2 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83815-8994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194136150 | Daniel B. Davidson | Dentist | 509 W Hanley Ave, Suite 201, Coeur D Alene, ID 83815-8994 | 2014-05-13 |
| 1477850873 | Kirk Michael Davidson | Dentist | 509 W Hanley Ave, Ste. 201, Coeur D Alene, ID 83815-8994 | 2011-02-21 |
| 1922267491 | Dr. Bryan Dryden Family Dentistry | Clinic/Center | 509 W Hanley Ave, Suite 102, Coeur D Alene, ID 83815-8994 | 2008-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790133163 | Christine Lee Stanton | Speech-Language Pathologist | 3825 N. Blalock Drive, Coeur D'alene, ID 83815 | 2016-05-26 |
| 1578921961 | Kayla Wearne | Speech-Language Pathologist | 917 W Canfield Avenue, Coeur D'alene, ID 83815 | 2016-02-01 |
| 1770954794 | William Strong | Speech-Language Pathologist | 3902 Broken Arrow Rd, Coeur D Alene, ID 83815 | 2015-10-16 |
| 1235517079 | Denny Bordeaux | Emergency Medical Technician, Paramedic | 7294 Downing Lane, Coeur D Alene, ID 83815 | 2015-05-13 |
| 1689075657 | Barbara Campbell | Pharmacist | W 201 Neider Rd., Coeur D'alene, ID 83815 | 2014-09-10 |
| 1710313671 | Sean Cooper | Pharmacist | W. 201 Neider Rd., Coeur D' Alene, ID 83815 | 2013-09-23 |
| 1275871329 | Lake City Dental | Dentist | 6176 Government Way, Coeur D'alene, ID 83815 | 2013-01-24 |
| 1881972701 | A Better Personal Care Inc | In Home Supportive Care | 3115 N Government Way Ste 2, Coeur D'alene, ID 83815 | 2011-07-26 |
| 1013206895 | Robert Sperry | Pharmacist | 41650 W Maricopacg Hwy., Maricopa, AZ 83815 | 2011-04-01 |
| 1629304670 | Marciea W. Buckley | Social Worker | 109 Harrison Ave, Coeur D' Alene, ID 83815 | 2009-10-27 |
| Find all providers in zip 83815 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275848582 | Shaun Michael Whitney | Dentist | 1322 W Kathleen Ave Ste 2, Coeur D Alene, ID 83815-7365 | 2010-08-11 |
| 1972660769 | Northwest Endodontics PC | Dentist | 509 W Hanley, Ste 202, Coeur D Alene, ID 83815 | 2007-01-02 |
| 1356693915 | Lake City Dental Specialties, PC | Dentist | 1322 W Kathleen Ave Ste 2, Coeur D Alene, ID 83815-7365 | 2012-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1417353830 | Blue Creek Endodontics | Dentist | 3240 E Louise Dr, Suite 110, Meridian, ID 83642-5107 | 2014-11-12 |
| 1831435460 | James Anthony Eaton | Dentist | 3240 E Louise Dr # 110, Meridian, ID 83642-5107 | 2013-01-01 |
| 1174888473 | Dean Philip Whiting | Dentist | 602 North Calgary Court, 301, Post Falls, ID 83854 | 2012-07-12 |
| 1437455961 | Herbert Ray Blaser | Dentist | 2104 N. Cole Rd., Boise, ID 83704 | 2011-02-01 |
| 1295035020 | Dustin Lee Gatten | Dentist | 602 N Calgary Ct Ste 301, Post Falls, ID 83854-4000 | 2010-10-27 |
| 1497918809 | Stanton D Widmer | Dentist | 4207 Clocktower Ave., Caldwell, ID 83607-5236 | 2008-07-07 |
| 1912113036 | Matthew R Buhrley | Dentist | 742 W Cherry Ln, Meridian, ID 83642-1617 | 2007-05-15 |
| 1659590693 | Bart Baty Morrison | Dentist | 3335 S Holmes Ave, Idaho Falls, ID 83404-7981 | 2007-04-25 |
| 1396961157 | Larue Antoine Bluth | Dentist | 5244 N Eagle Rd, Boise, ID 83713-0945 | 2007-04-18 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D ALENE |
| Zip Code | 83815 |
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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.