Andre Thibault, DDS, PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

6292 Issued in KS

Legal business name

ANDRE THIBAULT, DDS, PA

Practice address

3900 W Central Ave
Suite 100
Wichita, KS 67203-4928

Phone

(316) 616-1310

NPI assigned

Jun 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Andre Alan Thibault, DDS

Title

Owner

Phone

(316) 616-1310

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alan Thibault, D.D.S., P.A.

  • Endodontics
  • Wichita, KS
  • NPI 1003894684
  NPD (past)

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1013203728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034928",
            "telephone_number": "316-616-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672034928",
            "telephone_number": "316-616-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRE THIBAULT, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "THIBAULT",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-616-1310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "KS",
            "license": "6292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trey Anderson, DDS
• Valerie A. Anderson, RN, BSN, MSN, ARNP
• Andover Psychological Services PA
• Devon Frances Andra
• Andre Kandy, DDS, PA
• Barbara Ann Andres, MSW
• Andrew D Johnson DDS
• Alexandria Andrews, LMSW
• Kaya Andrews
• Miresha Andrews, CNA/HHA

• Endodontics in Wichita, KS
• Providers in Wichita, KS by specialty
• Endodontics in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.