Individual provider Active NPI

Bjorn Matthew Thorsen, D.D.S.

  • General Practice Dentistry
  • Stafford, VA
National Provider Identifier
1497141477
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401414828 Issued in VA
Practice address
385 Garrisonville Rd
Stafford, VA 22554
Phone
(540) 657-7645
NPI assigned
Apr 7, 2015
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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 0401414828 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

385 Garrisonville Rd
Stafford, VA 22554

Mailing address

1200 14TH St NW
Apt 404
Washington, DC 20005-4133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401414828VAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1497141477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 14TH ST NW",
            "address_2": "APT 404",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200054133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 GARRISONVILLE RD",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "540-657-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSEN",
        "first_name": "BJORN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-07",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414828",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.