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DR. TIMOTHY J CLEGG DDS NPI 1104819515


NPI Information

NPI: 1104819515
Provider Name: DR. TIMOTHY J CLEGG, DDS
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
36975 UTICA RD
SUITE 106
CLINTON TWP, MI
ZIP 48036
Phone: (586) 226-2801
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DR. Timothy J Clegg, DDS is an oral and maxillofacial surgery dentist in Clinton Twp, MI. The provider is an oral and maxillofacial surgery dentist specialized in 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. DR. Timothy J Clegg, DDS NPI is 1104819515. 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:

36975 UTICA RD
SUITE 106
CLINTON TWP, MI
ZIP 48036-685
Phone: (586) 226-2801
Fax: (586) 226-0929

The enumeration date for this NPI number is 8/31/2005 and was last updated on 9/12/2007.


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
11223S0112XDentistOral and Maxillofacial Surgery012043MICHIGANYes

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
1U21482MEDICARE UPINMICHIGAN
20E06224MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

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: 5/5/2024
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