Timothy L Ambrose, DDS in Gallup, NM - Medicare Dentist Provider

Timothy L Ambrose, DDS is a medicare enrolled "Dentist" provider in Gallup, New Mexico. His current practice location is 516 E. Nizhoni Blvd., Gallup, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 722-1000.

Timothy L Ambrose is licensed to practice in Nebraska (license number 5767) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1003850116.

Contact Information

	Timothy L Ambrose, DDS
	516 E. Nizhoni Blvd., Gallup, NM 87301-1337
	(505) 722-1000
	(505) 722-1565

Healthcare Provider's Profile

Full Name	Timothy L Ambrose
Gender	Male
Speciality	Dentist
Location	516 E. Nizhoni Blvd., Gallup, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003850116
Provider Enumeration Date: 06/16/2006
Last Update Date: 04/16/2008

Medicare PECOS Information:

PECOS PAC ID: 7012210206
Enrollment ID: I20160121001713

Medical Identifiers

Medical identifiers for Timothy L Ambrose such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003850116	NPI	-	NPPES
000R7575	Medicaid	NM
416455	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	5767 (Nebraska)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy L Ambrose is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Timothy L Ambrose, DDS Po Box 1337, Gallup, NM 87305-1337 Ph: (505) 722-1000	Timothy L Ambrose, DDS 516 E. Nizhoni Blvd., Gallup, NM 87301-1337 Ph: (505) 722-1000

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Dentist in Gallup, NM

Jovito G Sabal, D.D.S Dentist Medicare: Medicare Enrolled Practice Location: 516 E. Nizhoni Blvd, Box 1337, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1565
Dr. Gary Bruce Woodcock, D.M.D Dentist Medicare: Medicare Enrolled Practice Location: 516 East Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1560 Fax: 505-722-1563
Dr. Erin Maille Montano, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 802 Us Highway 491, Gallup, NM 87301 Phone: 505-862-5018
Dr. Dain Charles Hubley, DMD Dentist Medicare: Medicare Enrolled Practice Location: 516 E Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000
Bo Tran, DDS Dentist Medicare: Medicare Enrolled Practice Location: 516 East Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000
Dr. Eduardo J Valda, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 107 W Green St, Gallup, NM 87301 Phone: 505-870-6128

Timothy L Ambrose, DDS - Medicare Dentist in Gallup, NM