Jack B Thigpen III, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN 16908 Issued in FL

Practice address

10850 Sheldon Rd
Tampa, FL 33626-5117

Phone

(813) 926-5989

NPI assigned

Apr 23, 2008

Last updated

Sep 17, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 18, 2017 through Jul 18, 2027

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jack B. Thigpen, III, DMD, PA

  dba West Coast Center For Jaw Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Tampa, FL
  • NPI 1952672511
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1134394869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 S DAKOTA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062503",
            "telephone_number": "863-670-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 SHELDON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336265117",
            "telephone_number": "813-926-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIGPEN",
        "first_name": "JACK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN 16908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cora Elizabeth Thibodeau
• Elizabeth Ann Thiel, MS, MED
• Tara A Thiel, O.D.
• Neil Allen Thierry, M.D.
• Elizabeth Thigpen
• Puchong Thirawatananond, MD, PHD
• Thiru S. Arasu, M.D., P.a.
• Shimlanath Thiruvoth
• Thistle Family Chiropractic LLC
• Jacob Thoenen, MD

• Oral and Maxillofacial Surgery (Dentist) in Tampa, FL
• Providers in Tampa, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.