Individual provider Active NPI

Nithin Thampi

  • Dentist
  • Justin, TX
National Provider Identifier
1023518990
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38199 Issued in TX
Practice address
536 S FM 156
Justin, TX 76247-4600
Phone
(940) 784-5100
NPI assigned
Feb 17, 2018
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38199 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

536 S FM 156
Justin, TX 76247-4600

Mailing address

536 S FM 156
Justin, TX 76247-4600

Other practice location 1

27005 76th Ave
New Hyde Park, NY 11040-1402
Phone (718) 470-7000

Other practice location 2

290 Park Ave
Worcester, MA 01609-1805
Phone (508) 798-9040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190104000152 NY Order and Referring Only - DentistPractitioner - Dentist 0941546477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38199TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Worcester Smiles Youth Dentistry, LLC General Practice Past Accepting new patients
Worcester Hills Dental PC General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1518825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1023518990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 S FM 156",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "762474600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 S FM 156",
            "city": "JUSTIN",
            "state": "TX",
            "postal_code": "762474600",
            "telephone_number": "940-784-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "290 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016091805",
            "country_code": "US",
            "telephone_number": "508-798-9040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAMPI",
        "first_name": "NITHIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-17",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38199",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Justin, TX

Sources for this page

Verify at the official NPI Registry.