Healthcare Provider Details

I. General information

NPI: 1114112794
Provider Name (Legal Business Name): TIMOTHY BERNARD MEYERS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110A HOSPITAL DRIVE
SIMPSONVILLE SC
29681
US

IV. Provider business mailing address

110A HOSPITAL DRIVE
SIMPSONVILLE SC
29681
US

V. Phone/Fax

Practice location:
  • Phone: 864-987-7030
  • Fax: 864-987-0198
Mailing address:
  • Phone: 864-987-7030
  • Fax: 864-987-0198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number03812
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number11215
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number23232
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number11216
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: