Active NPI
Kenneth Darrell Thomas, D.D.S.
- Dentist
- Salt Lake City, UT
National Provider Identifier
1114020203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 135030
- Practice address
- 250 East 300 South
Suite 320
Salt Lake City, UT 84111 - Phone
- (801) 532-6279
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 135030 | UT | Primary |
Addresses
Primary practice location
250 East 300 South
Suite 320
Salt Lake City, UT 84111
Mailing address
250 East 300 South
Suite 320
Salt Lake City, UT 84111
Phone (801) 532-6279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135030 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114020203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 EAST 300 SOUTH",
"address_2": "SUITE 320",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84111",
"telephone_number": "801-532-6279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 EAST 300 SOUTH",
"address_2": "SUITE 320",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84111",
"telephone_number": "801-532-6279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "KENNETH",
"middle_name": "DARRELL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "135030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.