Provider Demographics
NPI:1457354870
Name:CANTY, TIMOTHY CHASE (DDS, MPH, MAGD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:CHASE
Last Name:CANTY
Suffix:
Gender:M
Credentials:DDS, MPH, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2868 STELZER RD UNIT 301
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3133
Mailing Address - Country:US
Mailing Address - Phone:184-774-0290
Mailing Address - Fax:
Practice Address - Street 1:8086 E BROAD ST
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-8024
Practice Address - Country:US
Practice Address - Phone:847-740-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX264301223G0001X
IL19-153201223G0001X
AKDENT13841223G0001X
OH30.0235851223G0001X
WI1002349-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice