MEDICARE: DR. TIMOTHY CHASE CANTY DDS, MPH, MAGD

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
1	1223G0001X	General Practice Dentistry	26430	TX
2	1223G0001X	General Practice Dentistry	19-15320	IL
3	1223G0001X	General Practice Dentistry	DENT1384	AK
4	1223G0001X	General Practice Dentistry	30.023585	OH
5	1223G0001X	General Practice Dentistry	1002349-15	WI

General Provider Information

NPI Number	:	1457354870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY CHASE CANTY DDS, MPH, MAGD

Provider Business Mailing Address
First Line	:	2868 STELZER RD UNIT 301
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3133
Country	:	US
Telephone Number	:	184-774-0290
Fax Number	:

Provider Business Practice Location Address
First Line	:	8086 E BROAD ST
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-8024
Country	:	US
Telephone Number	:	847-740-2900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/11/2025

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