Individual provider Active NPI

Larry D Thomas, DDS

  • Dentist
  • Lewisburg, TN
National Provider Identifier
1366448433
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5052 Issued in TN
Practice address
1360 S Ellington Pkwy
Lewisburg, TN 37091-4324
Phone
(931) 359-1993
Fax
(931) 359-7372
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5052 TN Primary

Addresses

Primary practice location

1360 S Ellington Pkwy
Lewisburg, TN 37091-4324

Mailing address

1360 S Ellington Pkwy
Lewisburg, TN 37091-4324
Phone (931) 359-1993

Other identifiers 1

IdentifierTypeStateIssuer
3225545MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20160502001259 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3173822863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5052TNMDDentist
5052TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Practice Group of Tennessee, PLLC Dentist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1366448433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 S ELLINGTON PKWY",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370914324",
            "telephone_number": "931-359-1993",
            "fax_number": "931-359-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 S ELLINGTON PKWY",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370914324",
            "telephone_number": "931-359-1993",
            "fax_number": "931-359-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "D5052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3225545",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, TN

Sources for this page

Verify at the official NPI Registry.