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NPI Code Detail

MEDICARE: DR. CELINE JOYCE CORNELIUS TIMOTHIUS BDS, MS, MSD

MEDICARE: DR. CELINE JOYCE CORNELIUS TIMOTHIUS BDS, MS, MSD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodonticsDNCS000610GA
21223P0300XPeriodonticsDNF000437GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073112512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CELINE JOYCE CORNELIUS TIMOTHIUS BDS, MS, MSD
Provider Business Mailing Address
First Line : 1430 JOHN WESLEY GILBERT DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30912-0001
Country : US
Telephone Number : 706-721-7913
Fax Number : 706-721-6778
Provider Business Practice Location Address
First Line : 1430 JOHN WESLEY GILBERT DR
Second Line :
City : AUGUSTA
State : GA
Zip : 30912-0001
Country : US
Telephone Number : 706-721-2441
Fax Number : 706-721-6778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2020
Last Update Date : 02/19/2026

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