Kenneth Wilson Thompson Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5216 Issued in VA

Practice address

107 Brook Ave.
South Hill, VA 23970

Phone

(434) 447-3309

Fax

(434) 447-8801

NPI assigned

Jan 14, 2010

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1306177357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 BROOK AVE.",
            "address_2": "P O BOX 455",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "23970",
            "telephone_number": "434-447-3309",
            "fax_number": "434-447-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 BROOK AVE.",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "23970",
            "telephone_number": "434-447-3309",
            "fax_number": "434-447-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KENNETH",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "5216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Sweeney, RD
• Stephanie Noelle Taylor, M.S.,CCC-SLP/L
• Bethlehem Yihun Teklu, MD
• Tessie Smith Sadler Inc
• The Empowerment Services Group Incorporated
• Dion Glenn Tomer, RN, FNP
• Michael John Tozzi, D.O.
• Tri County Gastroenterology PC
• Brittney Tripp, COTA/L
• Patrick Ufkes, MD

• All providers in South Hill, VA
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.