Individual provider Active NPI

Maya S Thompson, DMD

  • Pediatric Dentistry
  • West Collingswood, NJ
National Provider Identifier
1386135960
Registry record updated Jun 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02796300 Issued in NJ
Practice address
501 White Horse Pike
West Collingswood, NJ 08107-1729
Phone
(856) 854-1509
NPI assigned
May 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI02796300 NJ Primary

Addresses

Primary practice location

501 White Horse Pike
West Collingswood, NJ 08107-1729

Mailing address

501 White Horse Pike
West Collingswood, NJ 08107-1729
Phone (856) 854-1509

Other practice location 1

1910 Route 70 E Ste 9
Cherry Hill, NJ 08003-2123
Phone (856) 424-5955

Other practice location 2

11100 Euclid Ave
Cleveland, OH 44106-1716
Phone (216) 844-1000

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

LicenseStateTypeSpecialty
22DI02796300NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Duck Duck Tooth Pediatric Dentistry LLC Current Accepting new patients
Dentistry for Special People Pediatric Dentistry PastSince Jan 1, 2021 Accepting new patients
T'Zuna Bria Publishing Company, LLC PastSince Jan 1, 2021 Accepting new patients

Locations

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

Organizations & group practices 3

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": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656201600000",
    "number": "1386135960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WHITE HORSE PIKE",
            "city": "WEST COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081071729",
            "telephone_number": "856-854-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WHITE HORSE PIKE",
            "city": "WEST COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081071729",
            "telephone_number": "856-854-1509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1910 Route 70 E Ste 9",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080032123",
            "country_code": "US",
            "telephone_number": "856-424-5955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11100 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061716",
            "country_code": "US",
            "telephone_number": "216-844-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MAYA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-19",
        "last_updated": "2022-06-26",
        "certification_date": "2022-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02796300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Collingswood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2022; 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.