Alisha Nichols Thanos, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0000 Issued in CA

Practice address

3350 La Jolla Village Dr # 160
San Diego, CA 92161-3679

Phone

(858) 552-7525

Fax

(858) 552-7516

NPI assigned

Feb 6, 2016

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1454716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1316305246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 ROGERS ST UNIT 104",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605153679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR # 160",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921613679",
            "telephone_number": "858-552-7525",
            "fax_number": "858-552-7516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "965 Rogers St Unit 104",
            "address_purpose": "LOCATION",
            "city": "Downers Grove",
            "state": "IL",
            "postal_code": "605153679",
            "country_code": "US",
            "telephone_number": "818-400-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THANOS",
        "first_name": "ALISHA",
        "middle_name": "NICHOLS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-06",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "0000",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101945",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.