DR. TIMOTHY JASON LEMOINE DDS
NPI 1093394777
Dentist - Oral and Maxillofacial Surgery in Green Bay, WI
About Dr. Timothy Jason Lemoine Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. TIMOTHY JASON LEMOINE DDS (NPI 1093394777) is an individual oral and maxillofacial surgery provider in Green Bay, Wisconsin, licensed in Wisconsin (1002550-15) and active in the NPI registry since April 2021. He has opted out of Medicare through July 10, 2027.
NPPES Registry Identity
Specialties & Licenses
Accepted 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. Timothy Jason Lemoine Dds 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 July 10, 2025 through July 10, 2027.
Other Providers at the Same Location NPPES 7
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GREEN BAY, WI 54304
GREEN BAY, WI 54304
GREEN BAY, WI 54304
GREEN BAY, WI 54304
GREEN BAY, WI 54304
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Timothy Lemoine's NPI number?
The NPI number for Timothy Lemoine is 1093394777. It was assigned to this individual provider in the NPPES registry on April 7, 2021.
Where is Timothy Lemoine located?
Timothy Lemoine practices at 2353 S Ridge Rd, Green Bay, WI 54304. The listed phone number is (920) 499-0471.
What is Timothy Lemoine's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.
Is Timothy Lemoine enrolled in Medicare?
No. Timothy Lemoine has opted out of Medicare through July 10, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Timothy Lemoine accept?
Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental of Wisconsin, Inc. and Humana list Timothy Lemoine as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Timothy Lemoine was last updated on June 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Timothy Jason Lemoine, DDS · NPI 1093394777
Oral and Maxillofacial Surgery provider in Green Bay, Wisconsin. Individual provider, active in the CMS NPPES registry since April 7, 2021.
## Identity
- **NPI:** 1093394777 (Entity type: Individual)
- **Enumerated:** April 7, 2021
- **Primary specialty:** Dentist - Oral and Maxillofacial Surgery · taxonomy 1223S0112X
- **State license:** 1002550-15 (Wisconsin)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2353 S RIDGE RD, Green Bay, WI 54304-5069
- **Phone:** (920) 499-0471
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through July 10, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** June 19, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1093394777) · Data from the CMS NPPES public registry.