Thaer Basim Alqadoumi, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

100200 Issued in CA

Practice address

81735 US Highway 111
Suite a
Indio, CA 92201-0713

Phone

(760) 238-4533

NPI assigned

May 6, 2016

Last updated

Oct 16, 2022By the provider in NPPES

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665878400000",
    "number": "1487000592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81735 US HIGHWAY 111",
            "address_2": "SUITE A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010713",
            "telephone_number": "760-238-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81735 US HIGHWAY 111",
            "address_2": "SUITE A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922010713",
            "telephone_number": "760-238-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALQADOUMI",
        "first_name": "THAER",
        "middle_name": "BASIM",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-06",
        "last_updated": "2022-10-16",
        "certification_date": "2022-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100200",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "100200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Alexander, LCSW
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• Damian Allen
• Maria Eugenia Alonzo
• Francisco Jesus Altamirano
• Jennifer Altamirano
• Anthony Angel Alvarado
• Kimberly Alvarado
• Liliana Alvarado

• Periodontics in Indio, CA
• Providers in Indio, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.