Individual provider Active NPI

Shunda Thompson, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Houston, TX
National Provider Identifier
1285654830
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
23564 Issued in TX
Practice address
134 Vintage Park Blvd Ste a
Houston, TX 77070-3998
Phone
(832) 271-3200
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 23564 TX
Dentist 122300000X 23564 TX
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 23564 TX Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN012649 GA

Addresses

Primary practice location

134 Vintage Park Blvd Ste a
Houston, TX 77070-3998

Mailing address

12022 Via Palazzo LN
Cypress, TX 77429-7434
Phone (713) 775-2888

Other practice location 1

3063 S John Redditt Dr
Lufkin, TX 75904-5603
Phone (936) 465-9986

Other identifiers 3

IdentifierTypeStateIssuer
186495115MedicaidTX
18649114MedicaidTX
836857158CMedicaidGA

Other names 1

  • Shunda Thompson Banks Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23564TXMDGeneral Practice Dentistry
DN012649GAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lonestar Grins Dental and Orthodontics, PC Dentist CurrentSince Nov 12, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1285654830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12022 VIA PALAZZO LN",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774297434",
            "telephone_number": "713-775-2888",
            "fax_number": "281-359-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 VINTAGE PARK BLVD STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770703998",
            "telephone_number": "832-271-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3063 S John Redditt Dr",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759045603",
            "country_code": "US",
            "telephone_number": "936-465-9986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHUNDA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23564",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23564",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "23564",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN012649",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186495115",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18649114",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "836857158C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUNDA",
            "last_name": "THOMPSON BANKS",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.