DR. DEAN TIBORIS DMD - NPI 1003139700 - Oral & Maxillofacial Surgery in Kenosha, WI

Q: What is Dean Tiboris's NPI number?

The NPI number for Dean Tiboris is 1003139700. It was assigned to this individual provider in the NPPES registry on March 9, 2010.

Q: What is Dean Tiboris's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Q: Is Dean Tiboris enrolled in Medicare?

No. Dean Tiboris has opted out of Medicare through June 19, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Dean Tiboris was last updated on June 10, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Dean Tiboris Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DEAN TIBORIS DMD (NPI 1003139700) is an individual oral & maxillofacial surgery provider in Kenosha, Wisconsin, licensed in Wisconsin (7210-15) and active in the NPI registry since March 2010. He has opted out of Medicare through June 19, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1003139700

Entity TypeIndividualMale

Primary Taxonomy204E00000X

Provider Legal NameDR. DEAN TIBORISCredential: DMD

Location Address5021 WASHINGTON RDKenosha, WI 53144-4292

Mailing Address5021 Washington RdKenosha, WI 53144-4292 · (262) 654-6770 · Fax (262) 654-6727

Phone(262) 654-6770

Fax(262) 654-6727

Sole ProprietorYes

Enumeration DateMarch 9, 2010

Last NPPES UpdateJune 10, 2014

✔ NPI 1003139700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code204E00000X

License✔ Licensed in WI · 7210-15

Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

5021 WASHINGTON RD, Kenosha, WI 53144

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of Wisconsin, Inc., Guardian, Humana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Dean Tiboris Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 19, 2017 through June 19, 2027.

Opt-Out Effective DateJune 19, 2017

Opt-Out In Effect ThroughJune 19, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN M LINDELL DDS

Dentist (Endodontics)