Individual provider Active NPI

Aja Tranise Thompson

  • General Practice Dentistry
  • River Oaks, TX
National Provider Identifier
1053698118
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27014 Issued in TX
Practice address
5422 River Oaks Blvd
River Oaks, TX 76114-3349
Phone
(817) 984-8585
NPI assigned
Nov 3, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27014 TX Primary

Addresses

Primary practice location

5422 River Oaks Blvd
River Oaks, TX 76114-3349

Mailing address

4207 Live Oak St
#2303
Dallas, TX 75204-6705
Phone (678) 478-1091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160615001509 TX Order and Referring Only - DentistPractitioner - Dentist 4486945821

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27014TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1053698118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 LIVE OAK ST",
            "address_2": "#2303",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046705",
            "telephone_number": "678-478-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5422 RIVER OAKS BLVD",
            "city": "RIVER OAKS",
            "state": "TX",
            "postal_code": "761143349",
            "telephone_number": "817-984-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "AJA",
        "middle_name": "TRANISE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Oaks, TX

Sources for this page

Verify at the official NPI Registry.