Individual provider Active NPI

Thomas Joseph Demayo, D.D.S.

  • Endodontics
  • Virginia Beach, VA
National Provider Identifier
1215080262
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0401008038 Issued in VA
Practice address
762 Independence Blvd
Suite 400
Virginia Beach, VA 23455-6200
Phone
(757) 557-0600
Fax
(757) 557-0612
NPI assigned
Jan 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 0401008038 VA Primary

Addresses

Primary practice location

762 Independence Blvd
Suite 400
Virginia Beach, VA 23455-6200

Mailing address

1518 Stanfield Rd
Virginia Beach, VA 23455-4527
Phone (757) 363-2365

Medicare participation

Medicare enrollment files
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 Sep 25, 2017 through Sep 25, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401008038VAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215080262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 STANFIELD RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234554527",
            "telephone_number": "757-363-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 INDEPENDENCE BLVD",
            "address_2": "SUITE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556200",
            "telephone_number": "757-557-0600",
            "fax_number": "757-557-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAYO",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401008038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.