Michael J. Thorne D.D.S. Inc

Primary specialty

DentistTaxonomy code 122300000X

License

43868 Issued in CA

Legal business name

MICHAEL J. THORNE D.D.S. INC

Doing business as

Mission Dental Group

Practice address

26 S Garden St
Suite I & J
Ventura, CA 93001-4521

Phone

(805) 648-1090

Fax

(805) 641-9130

NPI assigned

Feb 5, 2007

Organization subpart

No

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

Authorized official

Name

Michael J Thorne, DDS

Title

President

Phone

(805) 648-1090

Specialties & licenses 1

Addresses

Other names 1

• Mission Dental Group Doing business as

Locations

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053450213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 S GARDEN ST",
            "address_2": "SUITE I & J",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930014521",
            "telephone_number": "805-648-1090",
            "fax_number": "805-641-9130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S GARDEN ST",
            "address_2": "SUITE I & J",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930014521",
            "telephone_number": "805-648-1090",
            "fax_number": "805-641-9130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. THORNE D.D.S. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THORNE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-648-1090",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Ventura, CA
• Providers in Ventura, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.