DR. TIMOTHY ALLEN THEISEN (NPI# 1700982378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700982378 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY ALLEN THEISEN |
| Credential | DDS, MS |
| Practice Address |
6050 Brynwood Dr Suite 201 Rockford IL 61114-6579 |
| Practice Telephone | 8158777079 |
| Mailing Telephone | 8158777079 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770959405 | Timothy Richard Theisen | Physical Therapy Assistant | 250 Gauger St Ne, Hutchinson, MN 55350-1707 | 2015-08-17 |
| 1003259797 | Timothy M Theisen | Dentist | 896 E 2nd St, Jamestown, NY 14701-3826 | 2013-04-11 |
| Street Address |
6050 BRYNWOOD DR SUITE 201 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114-6579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295951317 | Thomas Allen Daniels | Dentist | 6050 Brynwood Dr, Suite 201, Rockford, IL 61114-6579 | 2007-04-17 |
| 1598805822 | Kurt Fredric Jensen | Dentist | 6050 Brynwood Dr, Ste 102, Rockford, IL 61114-6579 | 2007-02-07 |
| 1700955606 | William G Shold | Dentist | 6050 Brynwood Dr, Suite 205, Rockford, IL 61114-6579 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295192078 | Orthodontic Experts | Dentist | 5051 E State St, Rockford, IL 61108-2310 | 2016-01-25 |
| 1215099114 | Mp Montaleone Dds Ltd | Dentist | 4312 E State St, Rockford, IL 61108 | 2006-12-15 |
| 1104915099 | Thomas Patrick Williams II | Dentist | 6840 Northway Dr Ne Ste C, Rockford, MI 49341-7569 | 2006-10-11 |
| 1841381761 | Dean J Murphy | Dentist | 2835 Mcfarland Rd, Rockford, IL 61107-6819 | 2006-09-27 |
| 1891742896 | Derek Sf Cheng | Dentist | 425 Roxbury Rd, Rockford, IL 61107 | 2006-05-27 |
| 1508845918 | Mark P. Brieden D.d.s., M.s., P.C. | Dentist | 158 Marcell Dr Ne, Rockford, MI 49341-1390 | 2006-01-13 |
| 1639152358 | Dennis Joseph Flanagan | Dentist | 1075 Featherstone Rd, Rockford, IL 61107-5906 | 2005-11-28 |
| 1861057119 | Alexis Leigh Gallagher | Dentist | 6840 Northway Dr Ne, Rockford, MI 49341-7568 | 2019-05-02 |
| 1609326743 | Lina Alsibaie | Dentist | 5051 E State St, Rockford, IL 61108-2310 | 2016-10-13 |
| 1851765945 | All Kids Dental Center, LLC. | Dentist | 555 N Court St, 100, Rockford, IL 61103-6862 | 2015-11-30 |
| Find all providers in ROCKFORD | ||||
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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.