NPIMap

Organization Active NPI

Thomas Dental Office PC

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1285896530
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12970 Issued in MO
Legal business name
THOMAS DENTAL OFFICE PC
Practice address
3737 N Kingshighway Blvd
Suite 108
Saint Louis, MO 63115-1736
Phone
(314) 389-7722
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Ms. Dorothy J Deavault
Title
Dental Assistant
Phone
(314) 389-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12970 MO Primary

Addresses

Primary practice location

3737 N Kingshighway Blvd
Suite 108
Saint Louis, MO 63115-1736

Mailing address

3737 N Kingshighway Blvd
Suite 108
Saint Louis, MO 63115-1736
Phone (314) 389-7722

Other identifiers 2

IdentifierTypeStateIssuer
400519328MedicaidMO
002362OtherWIDORAL DENTAL

Other names 1

  • cornell thomas Other name

National Provider Directory

National Provider Directory

Locations

3737 N Kingshighway Blvd
Ste 108
Saint Louis, MO 63115
Phone (314) 389-7722

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1285896530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 N KINGSHIGHWAY BLVD",
            "address_2": "SUITE 108",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151736",
            "telephone_number": "314-389-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 N KINGSHIGHWAY BLVD",
            "address_2": "SUITE 108",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631151736",
            "telephone_number": "314-389-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS DENTAL OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "DEAVAULT",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTAL ASSISTANT",
        "authorized_official_telephone_number": "314-389-9990",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400519328",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "002362",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "cornell thomas",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.