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DR. TIMOTHY WALTER PENBERTHY D.D.S.
NPI 1285786194
Dentist - Endodontics in Coeur D Alene, ID

Active since January 18, 2007Opted out of Medicare · through Mar 20, 2027
509 W HANLEY AVE, SUITE # 2, COEUR D ALENE, ID 83815(208) 664-8622 Get Directions Write a Review

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

About Dr. Timothy Walter Penberthy D.d.s. NPPES

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

DR. TIMOTHY WALTER PENBERTHY D.D.S. (NPI 1285786194) is an individual endodontics provider in Coeur D Alene, Idaho, licensed in Idaho (D-1930-EN) and active in the NPI registry since January 2007. He has opted out of Medicare through March 20, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1285786194
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. TIMOTHY WALTER PENBERTHYCredential: D.D.S.
Location Address509 W HANLEY AVE, SUITE # 2Coeur D Alene, ID 83815-8994
Mailing Address509 W Hanley Ave, Suite # 2Coeur D Alene, ID 83815-8994 · (208) 664-8622
Phone(208) 664-8622
Sole ProprietorNo
Enumeration DateJanuary 18, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1285786194 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in ID · D-1930-EN
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
509 W HANLEY AVE, Coeur D Alene, ID 83815
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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 Walter Penberthy 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 March 20, 2025 through March 20, 2027.

Opt-Out Effective DateMarch 20, 2025
Opt-Out In Effect ThroughMarch 20, 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83815 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

DANIEL B. DAVIDSON
Dentist (General Practice)
509 W HANLEY AVE, SUITE 201
COEUR D ALENE, ID 83815
Kootenai County (208) 667-5447
DR. KIRK MICHAEL DAVIDSON DDS
Dentist
509 W HANLEY AVE, STE. 201
COEUR D ALENE, ID 83815
Kootenai County (208) 667-5447
JACKSON FRENCH DMD
Dentist
509 W HANLEY AVE
COEUR D ALENE, ID 83815
Kootenai County (208) 667-5447
DR. BRYAN DRYDEN FAMILY DENTISTRY
Clinic/Center (Dental)
509 W HANLEY AVE, SUITE 102
COEUR D ALENE, ID 83815
Kootenai County (208) 664-9506

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 Penberthy's NPI number?

The NPI number for Timothy Penberthy is 1285786194. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Timothy Penberthy located?

Timothy Penberthy practices at 509 W Hanley Ave Suite # 2, Coeur D Alene, ID 83815. The listed phone number is (208) 664-8622.

What is Timothy Penberthy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Timothy Penberthy enrolled in Medicare?

No. Timothy Penberthy has opted out of Medicare through March 20, 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.

When was this NPI record last updated?

The NPPES record for Timothy Penberthy 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.