Tepphanie Phimeans Thach, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0023074 Issued in TX

Practice address

383 Greens Rd Ste a
Houston, TX 77060-1907

Phone

(281) 872-3777

NPI assigned

Dec 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Brident Dental Associates PC

  • Dentist
  • Houston, TX
  • NPI 1720552813
  NPD (past)
• South Texas Dental Associates, L.P.

  • General Practice Dentistry
  • Houston, TX
  • NPI 1508084906
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1073673281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 650",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012997",
            "telephone_number": "713-663-7960",
            "fax_number": "713-349-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 GREENS RD STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770601907",
            "telephone_number": "281-872-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACH",
        "first_name": "TEPPHANIE",
        "middle_name": "PHIMEANS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012969",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "0023074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609422190A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS MEDICAID",
            "identifier": "100201",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL MEDICAID",
            "identifier": "9181147",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TH Healthcare ,LTD.
• TH Healthcare ,LTD.
• TH Healthcare ,LTD.
• TH Livingtree of Texas
• Tha Spot Health and Human Resources Inc.
• John Thachil, MD
• Anmona Thacker, M.D.
• Bethany Miriya Thacker, LCSW
• Raven Thacker, NP
• Seema Thacker, MD

• Pediatric Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.