Individual provider Active NPI

Charne A Thomas, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1043877277
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7509 Issued in LA
Practice address
14891 Preston Rd Ste 200
Dallas, TX 75254-7870
Phone
(972) 661-2766
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 37224 TX
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 7509 LA Primary

Addresses

Primary practice location

14891 Preston Rd Ste 200
Dallas, TX 75254-7870

Mailing address

3407 Clarksville Pike Apt F
Nashville, TN 37218-2607

Other practice location 1

2138 Madison Ave
Toledo, OH 43604-5131
Phone (419) 227-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20260520003269 LA Practitioner - Dentist 0749759546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3201 S Carrollton Ave
New Orleans, LA 70118-4307

PO Box
Suite 13038
New Orleans, LA 70185-3038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7509LAMDGeneral Practice Dentistry
37224TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Preston Modern Dentistry, PC General Practice PastSince Jun 15, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1043877277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 CLARKSVILLE PIKE APT F",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372182607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14891 PRESTON RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752547870",
            "telephone_number": "972-661-2766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2138 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436045131",
            "country_code": "US",
            "telephone_number": "419-227-5544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHARNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "37224",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.