DR. TIMOTHY JAMES KOLL D.D.S.
NPI 1154403194
Dentist - Oral and Maxillofacial Pathology in Appleton, WI

Q: What is Timothy Koll's NPI number?

The NPI number for Timothy Koll is 1154403194. It was assigned to this individual provider in the NPPES registry on October 19, 2006.

Q: What is Timothy Koll's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

Q: Is Timothy Koll enrolled in Medicare?

No. Timothy Koll has opted out of Medicare through June 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Timothy Koll was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since October 19, 2006Opted out of Medicare · through Jun 7, 2028

2410 E. EVERGREEN DR., APPLETON, WI 54913(920) 832-9500(920) 832-9490 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Timothy James Koll D.d.s. NPPES

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

DR. TIMOTHY JAMES KOLL D.D.S. (NPI 1154403194) is an individual oral and maxillofacial pathology provider in Appleton, Wisconsin, licensed in Wisconsin (4243) and active in the NPI registry since October 2006. He has opted out of Medicare through June 7, 2028.

NPPES Registry Identity

NPI1154403194

Entity TypeIndividualMale

Primary Taxonomy1223P0106X

Provider Legal NameDR. TIMOTHY JAMES KOLLCredential: D.D.S.

Location Address2410 E. EVERGREEN DR.Appleton, WI 54913-4913

Mailing Address2410 E. Evergreen Dr.Appleton, WI 54913-4913 · (920) 832-9500 · Fax (920) 832-9490

Phone(920) 832-9500

Fax(920) 832-9490

Sole ProprietorNo

Enumeration DateOctober 19, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1154403194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers

Taxonomy Code1223P0106X

License✔ Licensed in WI · 4243

Definition

The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.

2410 E. EVERGREEN DR., Appleton, WI 54913

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Other Identifiers 2

Medicare ID-Type Unspecified78325WI

Medicare UPIN4-19648WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana 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. Timothy James Koll D.d.s. 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 7, 2022 through June 7, 2028.

Opt-Out Effective DateJune 7, 2022

Opt-Out In Effect ThroughJune 7, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

DR. HENRY STEVEN PLAUTZ DDS

Dentist (Oral and Maxillofacial Surgery)

2410 E. EVERGREEN DR.
APPLETON, WI 54913

Outagamie County (920) 832-9500

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 Koll's NPI number?

The NPI number for Timothy Koll is 1154403194. It was assigned to this individual provider in the NPPES registry on October 19, 2006.

Where is Timothy Koll located?

Timothy Koll practices at 2410 E. Evergreen Dr., Appleton, WI 54913. The listed phone number is (920) 832-9500.

What is Timothy Koll's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Pathology, with taxonomy code 1223P0106X.

Is Timothy Koll enrolled in Medicare?

No. Timothy Koll has opted out of Medicare through June 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Timothy Koll accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 7 other insurers list Timothy Koll 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 Koll was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.