Active NPI
Thomas Omar Adjan, DDS
- General Practice Dentistry
- Austin, TX
National Provider Identifier
1043775471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 34841
- Practice address
- 6104 S 1St St Ste 103
Austin, TX 78745-4052 - Phone
- (512) 222-9772
- NPI assigned
- Feb 11, 2019
- Last updated
- Dec 23, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 34841 | TX | Primary |
Addresses
Primary practice location
6104 S 1St St Ste 103
Austin, TX 78745-4052
Mailing address
6104 S 1St St Ste 103
Austin, TX 78745-4052
Phone (512) 222-9772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34841 | TX | MD | Ambulatory Care Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc Amsili DDS PA | General Practice | Past | 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, 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": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577059200000",
"number": "1043775471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6104 S 1ST ST STE 103",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787454052",
"telephone_number": "512-222-9772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6104 S 1ST ST STE 103",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787454052",
"telephone_number": "512-222-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADJAN",
"first_name": "THOMAS",
"middle_name": "OMAR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-11",
"last_updated": "2019-12-23",
"certification_date": "2019-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "34841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.