Organization Active NPI

Damon B Thompson DDS PC

  • Dentist
  • Blacksburg, VA
National Provider Identifier
1336461094
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8616 Issued in VA
Legal business name
DAMON B THOMPSON DDS PC
Practice address
202 S Main St
Suite 101
Blacksburg, VA 24060-4880
Phone
(540) 552-5433
Fax
(540) 552-2273
NPI assigned
Feb 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Authorized official

Name
Dr. Damon B. Thompson, DDS, PCNPI 1811071871
Title
Dentist
Phone
(540) 552-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 8616 VA Primary

Addresses

Primary practice location

202 S Main St
Suite 101
Blacksburg, VA 24060-4880

Mailing address

202 S Main St
Suite 101
Blacksburg, VA 24060-4880
Phone (540) 552-5433

Other identifiers 1

IdentifierTypeStateIssuer
9178608MedicaidVA

Other names 1

  • Real Life Dental Doing business as

National Provider Directory

National Provider Directory

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": "1266883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1336461094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240604880",
            "telephone_number": "540-552-5433",
            "fax_number": "540-552-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240604880",
            "telephone_number": "540-552-5433",
            "fax_number": "540-552-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMON B THOMPSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-23",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "540-552-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, PC"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "8616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9178608",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Real Life Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.