Provider Demographics
NPI:1598014037
Name:ZIGLER, TIMOTHY JASON (DDS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JASON
Last Name:ZIGLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45403-1991
Mailing Address - Country:US
Mailing Address - Phone:937-528-6830
Mailing Address - Fax:937-528-6840
Practice Address - Street 1:2132 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-1991
Practice Address - Country:US
Practice Address - Phone:937-528-6830
Practice Address - Fax:937-528-6840
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0241371223G0001X
IN12011798A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0097673Medicaid