Trevor Robert Norman Thorn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

62647 Issued in CA

Practice address

22629 Twain Harte Dr
Twain Harte, CA 95383-9405

Phone

(209) 586-2772

Fax

(209) 586-4612

NPI assigned

Oct 24, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Practice of DRS. McKelvey & Grossman, a Prof. Dental Corp.

  • General Practice Dentistry
  • Twain Harte, CA
  • NPI 1578885141
  NPD (past)

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1407284763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22629 TWAIN HARTE DR",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839405",
            "telephone_number": "209-586-2772",
            "fax_number": "209-586-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22629 TWAIN HARTE DR",
            "city": "TWAIN HARTE",
            "state": "CA",
            "postal_code": "953839405",
            "telephone_number": "209-586-2772",
            "fax_number": "209-586-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORN",
        "first_name": "TREVOR",
        "middle_name": "ROBERT NORMAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62647",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "FT4092261",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J. Morrison, D.D.S.
• Linda Sue Postma, RDHAP,RDH
• Krista Dawn Root, R.D.H.
• Edward Riley Russell, DDS
• Starshine Margarita Shirley, SLP
• Twain Harte School District
• Lisa Anne Vershay, RDH
• Wisteria Joy Wood, AMFT/APCC

• General Practice Dentistry in Twain Harte, CA
• Providers in Twain Harte, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; 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.