TIMOTHY J KOOB (NPI# 1538104088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538104088 |
| Entity Type | Individual |
| Full Name | TIMOTHY J KOOB |
| Credential | DDS |
| Practice Address |
5801 Research Park Blvd Ste 110 Madison WI 53719-6002 |
| Mailing Address |
3146 Waucheeta Trl Madison WI 53711-5952 |
| Practice Telephone | 6082740770 |
| Practice Fax Number | 6082749224 |
| Mailing Telephone | 6082228093 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5109 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33754500 | 05 | |
| WI | DEAN HEALTH PLAN | 12127 | 01 |
| Street Address |
5801 RESEARCH PARK BLVD STE 110 |
| City | MADISON |
| State | WI |
| Zip Code | 53719-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669474508 | Brenda L Casey | Obstetrics & Gynecology | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2005-08-11 |
| 1487023297 | Share The Health Free Gynecology Clinic, Inc. | Obstetrics & Gynecology | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2015-09-22 |
| 1578990354 | Stephanie Brasser | Nurse Practitioner | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2013-10-11 |
| 1669738233 | Shefaali Sharma | Obstetrics & Gynecology | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2012-04-07 |
| 1679886493 | Patricia D Thornewell | Pharmacist | 5801 Research Park Blvd, Madison, WI 53719 | 2010-07-21 |
| 1619296514 | Sarah L Yanke | Obstetrics & Gynecology | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2010-05-18 |
| 1174851851 | Madison Women's Health, LLP | Obstetrics & Gynecology | 5801 Research Park Blvd, Suite 400, Madison, WI 53719-6002 | 2009-11-18 |
| 1568499101 | Patrick J Lorge | Dentist | 5801 Research Park Blvd, Ste 110, Madison, WI 53719-6002 | 2006-06-27 |
| 1740216712 | Christopher J Bacsik | Dentist | 5801 Research Park Blvd, Ste 110, Madison, WI 53719-6002 | 2006-06-23 |
| 1497791644 | Scott A Hoyer | Dentist | 5801 Research Park Blvd, Ste 110, Madison, WI 53719-6002 | 2006-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003457441 | Madison Dentistry LLC | Dentist | 268 Main Street, Suite B, Madison, NJ 07940 | 2019-10-07 |
| 1093154601 | Matthew D Reiland | Dentist | 2921 Landmark Pl Ste 100, Madison, WI 53713-4248 | 2013-06-17 |
| 1720202153 | Stephen Charles Greer II Dmd | Dentist | 401 Baptist Drive, Suite 207, Madison, MS 39110 | 2007-04-13 |
| 1164599460 | David Franklin Butler | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2006-11-29 |
| 1598788796 | Mark K Jackson | Dentist | 7007 Old Sauk Road, Madison, WI 53717 | 2006-07-26 |
| 1891727152 | Karen S Ablow | Dentist | 145 Durham Road, Madison, CT 06443 | 2006-07-07 |
| 1851373625 | Jeffrey Scott Brown | Dentist | 106 Highland Way Ste 207, Madison, MS 39110-6930 | 2005-11-17 |
| 1700273208 | North Alabama Oral and Facial Surgery LLC | Dentist | 44 Hughes Rd, Madison, AL 35758-3045 | 2015-04-22 |
| 1174928709 | David F Butler, Dds | Dentist | 505 Cragmont St, Madison, IN 47250-3003 | 2014-10-24 |
| 1346576915 | Madison Oral and Facial Surgery, LLC | Dentist | 44 Hughes Rd, Suite 1500, Madison, AL 35758-2237 | 2009-11-02 |
| Find all providers in MADISON | ||||
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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.