MR. TIMOTHY MCMICHAEL THEISEN DMD NPI 1003259797

NPI Information

NPI: 1003259797
Provider Name: MR. TIMOTHY MCMICHAEL THEISEN, DMD
Classification: Dentist - 122300000X
Entity Type: Individual
PECOS Registration: Yes
Address: 4330 PEACH ST
ERIE, PA
ZIP 16509
Phone: (814) 315-6209

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NPI Details

MR. Timothy Mcmichael Theisen, DMD is a dentist in Erie, PA. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. MR. Timothy Mcmichael Theisen, DMD NPI is 1003259797. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4330 PEACH ST
ERIE, PA
ZIP 16509-443
Phone: (814) 315-6209
Fax: (814) 315-6303

The NPI 1003259797 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 4/11/2013 and was last updated on 8/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	122300000X	Dentist		DS038461	PENNSYLVANIA	Yes
2	1223E0200X	Dentist	Endodontics	DS038461	PENNSYLVANIA	No
3	1223G0001X	Dentist	General Practice	DS038461	PENNSYLVANIA	No
4	1223P0221X	Dentist	Pediatric Dentistry	DS038461	PENNSYLVANIA	No
5	1223P0700X	Dentist	Prosthodontics	DS038461	PENNSYLVANIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	056582	OTHER	NEW YORK	NYS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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