Scott Andrew Thayer, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

35011 Issued in TX

Practice address

2419 Palermo Pkwy
Building D
Temple, TX 76502

Phone

(254) 294-5775

NPI assigned

Jul 15, 2016

Last updated

Dec 9, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, TX2 enrollments

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 2

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.

• Scott a. Thayer DDS, Ms, PLLC

  dba Leon River Endodontics

  • Endodontics
  • Temple, TX
  • NPI 1780477232
  NPD Authorized official

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1265885180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 PALERMO PKWY",
            "address_2": "BUILDING D",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76502",
            "telephone_number": "254-294-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 PALERMO PKWY",
            "address_2": "BUILDING D",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76502",
            "telephone_number": "254-294-5775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3811 Stoneparc Dr",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "77802",
            "country_code": "US",
            "telephone_number": "979-846-2626",
            "fax_number": "979-846-2172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3811 Stoneparc Dr",
            "address_purpose": "LOCATION",
            "city": "Bryan",
            "state": "TX",
            "postal_code": "77802",
            "country_code": "US",
            "telephone_number": "979-846-2626",
            "fax_number": "979-846-2172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAYER",
        "first_name": "SCOTT",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35011",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "35011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endodontics in Temple, TX
• Providers in Temple, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.