David E Thome DDS PLLC IV

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9277 Issued in NC

Legal business name

DAVID E THOME DDS PLLC IV

Practice address

1454 Fern Creek Drive
Statesville, NC 28625

Phone

(980) 223-2607

Fax

(980) 223-6064

NPI assigned

Jan 22, 2015

Organization subpart

No

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

Authorized official

Name

Lucenda Harris

Title

Credentialing & Contracting Coordin

Phone

(980) 729-5200

Specialties & licenses 1

Addresses

Other names 1

• Statesville Pediatric Dentistry Doing business as

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1356730741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530172",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530172",
            "telephone_number": "980-729-5200",
            "fax_number": "704-943-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 FERN CREEK DRIVE",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "28625",
            "telephone_number": "980-223-2607",
            "fax_number": "980-223-6064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1209 Davie Ave",
            "address_purpose": "LOCATION",
            "city": "Statesville",
            "state": "NC",
            "postal_code": "286773511",
            "country_code": "US",
            "telephone_number": "704-604-0353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAVID E THOME DDS PLLC IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-22",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-16",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LUCENDA",
        "authorized_official_title_or_position": "CREDENTIALING & CONTRACTING COORDIN",
        "authorized_official_telephone_number": "980-729-5200"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "9277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Statesville Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Statesville Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Esenam Dankwa, PMHNP
• Jaan Dar
• Katherine Grace Darrigrand, DO
• Megan Daughaday
• David E Thome DDS PLLC I
• David E Thome DDS PLLC L1
• Ashma Shalonda Davidson, D.P.M.
• Beth Barbee Davidson, RPH
• Christian Noel Davidson, LCMHC, LCAS
• Amy Lynn Davis, LCSW

• Pediatric Dentistry in Statesville, NC
• Providers in Statesville, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.