Individual provider Active NPI

Michael Alan Thomas II, DMD

  • Dentist
  • Largo, FL
National Provider Identifier
1093397499
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN25953 Issued in FL
Practice address
10427 Ulmerton Rd Ste B-3
Largo, FL 33771-3530
Phone
(727) 535-9993
NPI assigned
Apr 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN25953 FL Primary

Addresses

Primary practice location

10427 Ulmerton Rd Ste B-3
Largo, FL 33771-3530

Mailing address

11850 Dr Martin L King St N Apt 13203
St Petersburg, FL 33716-1633
Phone (336) 212-0481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210727000146 FL Order and Referring Only - DentistPractitioner - Dentist 4880097013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist CurrentSince Jun 22, 2021 Accepting new patients
Coast Florida P.a. Dentist PastSince May 16, 2021 Accepting new patients

Locations

10427 Ulmerton Rd
Ste B3
Largo, FL 33771
Phone (727) 535-9993

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": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1093397499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 DR MARTIN L KING ST N APT 13203",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161633",
            "telephone_number": "336-212-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10427 ULMERTON RD STE B-3",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337713530",
            "telephone_number": "727-535-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-25",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN25953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.