Doctor profile · Federal record
Dr. Timothy Supan, D.M.D.
General Practice Dentistry · Gridley, IL
- NPI 1053316463
- 21 yrs on file
- Male
- No sanctions
Practice & contact
- Primary practice
-
205 E Gridley RD
Gridley, IL 617448733
(309) 747-2213
fax (309) 747-3989 - Mailing address
-
Po Box 197
Gridley, IL 617440197
Credentials & registration
- NPI registered
- June 2005 — 21 yrs on file
- Profile last updated
- July 8, 2007
- Specialty taxonomy
- 1223G0001X — NUCC code
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1053316463. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$27
Transactions
2
Manufacturers
2
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Dentsply Sirona INC | 1 | $14.90 | |
| Ultradent Products INC | 1 | $11.79 |
By nature of payment
Medicare Part D · 2023
Top prescriptions
Total claims
104
Patients
38
Total drug cost
$394
| Drug | Type | Claims | Patients | Total cost |
|---|---|---|---|---|
| Amoxicillin | Generic | 91 | 38 | $138 |
| Prevident (Fluoride (Sodium)) | Brand | 13 | 0 | $257 |
Frequently asked questions
What is Dr. Timothy Supan's medical specialty?
Dr. Timothy Supan practices General Practice Dentistry in Gridley, IL.
Where does Dr. Timothy Supan practice?
Dr. Timothy Supan practices at 205 E Gridley RD, Gridley, IL 617448733. Office phone: 3097472213.
What is Dr. Timothy Supan's NPI?
Dr. Timothy Supan's National Provider Identifier (NPI) is 1053316463, issued by NPPES.