Individual provider Active NPI

Todd Matthew Thurman, DMD, FAGD

  • General Practice Dentistry
  • Independence, KY
National Provider Identifier
1386219707
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10621 Issued in KY
Practice address
2052 Harris Pike # 54
Independence, KY 41051-7783
Phone
(859) 898-2255
NPI assigned
May 27, 2021
Last updated
Jul 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30.026976 OH
General Practice Dentistry 1223G0001X 10621 KY Primary

Addresses

Primary practice location

2052 Harris Pike # 54
Independence, KY 41051-7783

Mailing address

328 Cornwall Dr
Florence, KY 41042-9207
Phone (502) 435-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20210707003021 KY Order and Referring Only - DentistPractitioner - Dentist 2860894243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10621KYMDGeneral Practice Dentistry
30.026976OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mortenson Family Dental Center - Independence, LLC General Practice PastSince Jul 24, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1386219707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 CORNWALL DR",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410429207",
            "telephone_number": "502-435-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 HARRIS PIKE # 54",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517783",
            "telephone_number": "859-898-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "TODD",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD, FAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026976",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KY

Sources for this page

Verify at the official NPI Registry.