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TIMOTHY E MICKIEWICZ DDS
NPI 1346393105
Dentist - General Practice in Sacramento, CA

Active since January 18, 2007Opted out of Medicare · through Mar 27, 2028
930 ALHAMBRA BLVD, STE 110, SACRAMENTO, CA 95816(916) 469-9178 Get Directions Write a Review

NPPES record last updated: March 7, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Timothy E Mickiewicz Dds NPPES

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

TIMOTHY E MICKIEWICZ DDS (NPI 1346393105) is an individual general practice provider in Sacramento, California, licensed in California (30810) and active in the NPI registry since January 2007. He has opted out of Medicare through March 27, 2028.

NPPES Registry Identity

NPI1346393105
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameTIMOTHY E MICKIEWICZCredential: DDS
Location Address930 ALHAMBRA BLVD, STE 110Sacramento, CA 95816-4479
Mailing Address930 Alhambra Blvd, Ste 110Sacramento, CA 95816-4479 · (916) 469-9178 · Fax (916) 246-0574
Phone(916) 469-9178
Sole ProprietorNo
Enumeration DateJanuary 18, 2007
Last NPPES UpdateMarch 7, 2018
✔ NPI 1346393105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 30810
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
930 ALHAMBRA BLVD, Sacramento, CA 95816
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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

Timothy E Mickiewicz 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 March 27, 2026 through March 27, 2028.

Opt-Out Effective DateMarch 27, 2026
Opt-Out In Effect ThroughMarch 27, 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. ALEXANDRA LYN WATKINS D.C.
Chiropractor
930 ALHAMBRA BLVD, 60
SACRAMENTO, CA 95816
Sacramento County (916) 441-2501

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 Mickiewicz's NPI number?

The NPI number for Timothy Mickiewicz is 1346393105. It was assigned to this individual provider in the NPPES registry on January 18, 2007.

Where is Timothy Mickiewicz located?

Timothy Mickiewicz practices at 930 Alhambra Blvd Ste 110, Sacramento, CA 95816. The listed phone number is (916) 469-9178.

What is Timothy Mickiewicz's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Timothy Mickiewicz enrolled in Medicare?

No. Timothy Mickiewicz has opted out of Medicare through March 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Timothy Mickiewicz was last updated on March 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.