DR. TIMOTHY JASON LEMOINE DDS
NPI 1093394777
Dentist - Oral and Maxillofacial Surgery in Green Bay, WI
NPI Status: Active since April 07, 2021
Contact Information
2353 S RIDGE RD
GREEN BAY, WI
ZIP 54304
Phone: (920) 499-0471
- Individual
- Male
- Dentist
- Oral and Maxillofacial Surgery
- Accepts Insurance
- Opted-Out Medicare
About TIMOTHY LEMOINE
This page provides the complete NPI Profile along with additional information for Timothy Lemoine, a provider established in Green Bay, Wisconsin with a medical specialization in Dentist, focusing in oral and maxillofacial surgery . The healthcare provider is registered in the NPI registry with number 1093394777 assigned on April 2021. The practitioner's primary taxonomy code is 1223S0112X with license number 1002550-15 (WI). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1093394777
- Provider Name
- DR. TIMOTHY JASON LEMOINE DDS
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2353 S RIDGE RD GREEN BAY, WI 54304
- Location Phone
- (920) 499-0471
- Mailing Address
- 2353 S RIDGE RD GREEN BAY, WI 54304
- Mailing Phone
- (920) 499-0471
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-07-2021
- Last Update Date
- 06-19-2025
- Code Navigator
A dentist like Timothy Lemoine is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Timothy Lemoine opted out of Medicare effective on 07-10-2025 until 07-10-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Oral and Maxillofacial Surgery
- Taxonomy Code
- 1223S0112X
- Type
- Dental Providers
- License No.
- 1002550-15
- License State
- WI
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- BlueCare Dental? 1D - PPO
- BlueCare Dental 1D - PPO
- BlueCare Dental 4 Kids? 1A - PPO
- BlueCare Dental 4 Kids? 1B - PPO
- BlueCare Dental? 1A - PPO
- BlueCare Dental? 1B - PPO
- BlueCare Dental? 1C - PPO
- Delta Dental Individual and Family High Plan - PPO
- Delta Dental Individual and Family Low Plan - PPO
- Delta Dental Individual and Family Low Plan Major - PPO
- Delta Dental PPO Plus Premier Family Plan High Option - PPO
- Delta Dental PPO Plus Premier Family Plan Low Option - PPO
- Humana Dental Smart Choice - PPO
- Humana Dental Smart Choice - Basic - PPO
- Humana Dental Smart Choice - High - PPO
- Humana Dental Smart Choice - Lite - PPO
- Humana Dental Smart Choice - Low - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-10-2025
Opt-Out End Date: 07-10-2027
Eligible to Order and Refer? No
Reviews for DR. TIMOTHY JASON LEMOINE DDS
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1093394777, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
GREEN BAY, WI 54304
GREEN BAY, WI 54304
GREEN BAY, WI 54304
GREEN BAY, WI 54304
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1093394777, enumerated as an "individual" on April 07, 2021.
The provider is located at 2353 S RIDGE RD GREEN BAY, WI 54304 and the phone number is (920) 499-0471.
Dentist with taxonomy code 1223S0112X and a focus in Oral and Maxillofacial Surgery.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana, Blue Cross. Please consult your insurance carrier or call the provider to verify.
