Individual provider Active NPI

Stephen William Thomas, DDS

  • General Practice Dentistry
  • Menomonee Falls, WI
National Provider Identifier
1003012709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3457015 Issued in WI
Practice address
N84 W15865 Appleton Ave
Menomonee Falls, WI 53051
Phone
(262) 251-6980
Fax
(262) 251-6982
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3457015 WI Primary

Addresses

Primary practice location

N84 W15865 Appleton Ave
Menomonee Falls, WI 53051

Mailing address

N84 W15865 Appleton Ave
Menomonee Falls, WI 53051
Phone (262) 251-6980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160614002381 WI Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7719278290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3457015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Dental PastSince Nov 12, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003012709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N84 W15865 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "53051",
            "telephone_number": "262-251-6980",
            "fax_number": "262-251-6982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N84 W15865 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "53051",
            "telephone_number": "262-251-6980",
            "fax_number": "262-251-6982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "3457015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.