Kenneth J. Thomas, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401410713 Issued in VA

Practice address

4000 Virginia St
Fairfax, VA 22032-1047

Phone

(703) 273-1443

Fax

(703) 273-9186

NPI assigned

Mar 22, 2007

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

Enrolled in VA

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

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265558738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 SHOLES CT",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201873909",
            "telephone_number": "703-273-1443",
            "fax_number": "703-273-9186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 VIRGINIA ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321047",
            "telephone_number": "703-273-1443",
            "fax_number": "703-273-9186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KENNETH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ernestine Augusta Thomas, M.D.
• Glenda Thomas, DNP-FNP
• Jade Angelyca Thomas, LCSW
• Jon L Thomas, LPC
• Karen Thomas, L.C.S.W
• Kyle Chacko Thomas, OTR/L
• Lisseth Carmen Thomas, PHD
• Nicole Marie Saddic Thomas, MD
• Sharnece Ayana Thomas, NCC, LMHC, LPC
• Sharon Straw Thomas, LPC

• Dentist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dentist in Virginia

• 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.