Michael David Thompson, DDS, FAGD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

011494 Issued in MO

Practice address

3551 Amazonas Dr
Jefferson City, MO 65109-5717

Phone

(573) 634-2400

Fax

(573) 761-7528

NPI assigned

Nov 17, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1417939174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 AMAZONAS DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095717",
            "telephone_number": "573-634-2400",
            "fax_number": "573-761-7528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 AMAZONAS DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095717",
            "telephone_number": "573-634-2400",
            "fax_number": "573-761-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "DDS, FAGD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "011494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Anne Thomas, DNP, APRN, FNP-BC
• Sophia Jolynn Thomas
• Sylvia Grace Thomas, ANP
• Richard Paul Thomlinson, PHD
• Kenyatta M. Thompson-Miller, LMSW
• Reese E. Thompson, M.D.
• Lyndsey Jo Thorne, FNP-BC
• Three Rivers Hospice, Inc. (Three Rivers Hospice Central)
• Ryan Matthew Thurman, PTA
• Emily Amber Tichich, CF-SLP

• General Practice Dentistry in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.