Thomas Raymond Bacon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1486 Issued in NH

Practice address

200 Broad St
Claremont, NH 03743-2685

Phone

(603) 542-5197

Fax

(603) 542-3531

NPI assigned

Jan 13, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in NH

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

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.

• Thomas R. Bacon, DDS,PA

  • General Practice Dentistry
  • Claremont, NH
  • NPI 1023212354
  NPD (past) Authorized official
• Claremont Dental Group PLLC

  • General Practice Dentistry
  • Claremont, NH
  • NPI 1902343809
  NPD (past)

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

{
    "created_epoch": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184775660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 KINGSFORD RD",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037552210",
            "telephone_number": "603-643-6013",
            "fax_number": "603-542-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BROAD ST",
            "city": "CLAREMONT",
            "state": "NH",
            "postal_code": "037432685",
            "telephone_number": "603-542-5197",
            "fax_number": "603-542-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "THOMAS",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "1486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Anderson
• Dea Candice Applegate, MSW
• Nancy S Arnold, NP
• Associates in Surgery & Gastroenterology, LLC
• Amanda M Ayer, PTA, LMT, CMT, CRM
• Zuha Bajwa, PHARMD
• Erik Baker
• Suellen Tucker Balestra, MD
• Todd Balise
• William J Ballantyne, PSYD

• General Practice Dentistry in Claremont, NH
• Providers in Claremont, NH by specialty
• General Practice Dentistry in New Hampshire

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.