Jessica Thayer, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D009928 Issued in AZ

Practice address

1048 Union St
Bangor, ME 04401-3016

Phone

(207) 404-8200

Fax

(207) 947-0435

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1427537513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 E WELDON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145046",
            "telephone_number": "928-301-4442",
            "fax_number": "505-899-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013016",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5757 W Thunderbird Rd Ste E451",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853064645",
            "country_code": "US",
            "telephone_number": "602-345-7959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAYER",
        "first_name": "JESSICA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AZ",
            "license": "D009928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DEN4740",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Teele, CCP
• Nina Tekelenburg
• Lucus Temple, LMSW-CC
• Diane Alicia Tennies, PH.D.
• Manika Thakur, MD
• The Aware Center for Early Intervention, LLC
• The Bangor Area Homeless Shelter
• The Bodyworks
• The Getchell Agency, Inc
• The Getchell Agency, Inc

• Orthodontics and Dentofacial Orthopedics Dentistry in Bangor, ME
• Providers in Bangor, ME by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.