Active NPI
Andrew John Thanos, DDS
- Dentist
- Menominee, MI
National Provider Identifier
1295043651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901010281
- Practice address
- 1201 10TH Street
Menominee, MI 49858 - Phone
- (906) 863-9203
- Fax
- (906) 863-9205
- NPI assigned
- Sep 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901010281 | MI | Primary |
Addresses
Primary practice location
1201 10TH Street
Menominee, MI 49858
Mailing address
1201 10TH Street
Menominee, MI 49858
Phone (906) 863-9203
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901010281 | Other | MI | STATE LICENSE NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901010281 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1295043651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 10TH STREET",
"city": "MENOMINEE",
"state": "MI",
"postal_code": "49858",
"telephone_number": "906-863-9203",
"fax_number": "906-863-9205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 10TH STREET",
"city": "MENOMINEE",
"state": "MI",
"postal_code": "49858",
"telephone_number": "906-863-9203",
"fax_number": "906-863-9205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THANOS",
"first_name": "ANDREW",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901010281",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "2901010281",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menominee, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.