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DR. TIMOTHY J SHAMBAUGH DDS
NPI 1124038260
Dentist - Oral and Maxillofacial Surgery in Fort Wayne, IN

Active since August 09, 2006
4606 D EAST STATE BLVD, FORT WAYNE, IN 46815(260) 423-2340(260) 422-5342 Get Directions Write a Review

NPPES record last updated: July 1, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Timothy J Shambaugh Dds NPPES

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

DR. TIMOTHY J SHAMBAUGH DDS (NPI 1124038260) is an individual oral and maxillofacial surgery provider in Fort Wayne, Indiana, licensed in Indiana (127177) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1124038260
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. TIMOTHY J SHAMBAUGHCredential: DDS
Location Address4606 D EAST STATE BLVDFort Wayne, IN 46815-6963
Mailing Address4606 D East State BlvdFort Wayne, IN 46815-6963 · (260) 423-2340 · Fax (260) 422-5342
Phone(260) 423-2340
Fax(260) 422-5342
Sole ProprietorNo
Enumeration DateAugust 9, 2006
Last NPPES UpdateJuly 1, 2008
✔ NPI 1124038260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in IN · 127177
Definition
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.
4606 D EAST STATE BLVD, Fort Wayne, IN 46815
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Other Identifiers 4

Medicaid200029030IN
Medicare PIN204070IN
Medicare PIN256430BIN
Medicare UPINT34489IN

Other Providers at the Same Location NPPES 2

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

DR. JOHN E BUHLER JR DDS
Dentist (Oral and Maxillofacial Surgery)
4606 D EAST STATE BLVD
FORT WAYNE, IN 46815
Allen County (260) 423-2340
DR. DAVID G BOJRAB DDS
Dentist (Oral and Maxillofacial Surgery)
4606 D EAST STATE BLVD
FORT WAYNE, IN 46815
Allen County (260) 423-2340

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 Shambaugh's NPI number?

The NPI number for Timothy Shambaugh is 1124038260. It was assigned to this individual provider in the NPPES registry on August 9, 2006.

Where is Timothy Shambaugh located?

Timothy Shambaugh practices at 4606 D East State Blvd, Fort Wayne, IN 46815. The listed phone number is (260) 423-2340.

What is Timothy Shambaugh's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Timothy Shambaugh was last updated on July 1, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.