Individual provider Active NPI

Thomas Andrew Conner, D.D.S.

  • Dentist
  • Chesterfield, VA
National Provider Identifier
1578863403
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401007258 Issued in VA
Practice address
9510 Iron Bridge Rd
Suite 100
Chesterfield, VA 23832-6400
Phone
(804) 768-7600
Fax
(804) 768-0115
NPI assigned
Oct 26, 2010
Last updated
Jun 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401007258 VA Primary

Addresses

Primary practice location

9510 Iron Bridge Rd
Suite 100
Chesterfield, VA 23832-6400

Mailing address

9510 Iron Bridge Rd
Suite 100
Chesterfield, VA 23832-6400
Phone (804) 768-7600

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
0401007258VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1578863403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9510 IRON BRIDGE RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326400",
            "telephone_number": "804-768-7600",
            "fax_number": "804-768-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9510 IRON BRIDGE RD",
            "address_2": "SUITE 100",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238326400",
            "telephone_number": "804-768-7600",
            "fax_number": "804-768-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "THOMAS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-26",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401007258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.