Active NPI
Jeromy L Thornton, DDS
- General Practice Dentistry
- Dallas, TX
National Provider Identifier
1376856534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 25808
- Practice address
- 3306 W Camp Wisdom Rd
Suite 100
Dallas, TX 75237-2596 - Phone
- (972) 709-4867
- NPI assigned
- Jul 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 25808 | TX | Primary |
Addresses
Primary practice location
3306 W Camp Wisdom Rd
Suite 100
Dallas, TX 75237-2596
Mailing address
7301 State Highway 161
Suite 198
Irving, TX 75039-2816
Phone (972) 869-3789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25808 | TX | MD | Psychiatric Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279238400000",
"number": "1376856534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7301 STATE HIGHWAY 161",
"address_2": "SUITE 198",
"city": "IRVING",
"state": "TX",
"postal_code": "750392816",
"telephone_number": "972-869-3789",
"fax_number": "972-869-3791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3306 W CAMP WISDOM RD",
"address_2": "SUITE 100",
"city": "DALLAS",
"state": "TX",
"postal_code": "752372596",
"telephone_number": "972-709-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "JEROMY",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-16",
"last_updated": "2010-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "25808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.