Tami M Thornberry Kidney, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011351 Issued in GA

Practice address

165 Juniper Circle
Brunswick, GA 31520

Phone

(912) 554-4552

Fax

(912) 554-0343

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgia Dental Professionals, PC

  dba Seaside Lifetime Dentistry

  • General Practice Dentistry
  • Brunswick, GA
  • NPI 1124576954
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1598833121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 JUNIPER CIRCLE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-554-4552",
            "fax_number": "912-554-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 JUNIPER CIRCLE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-554-4552",
            "fax_number": "912-554-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBERRY KIDNEY",
        "first_name": "TAMI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN011351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000654783D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Sue Thompson, M. D.
• Stephen James Thompson, M.D.
• Tyler McPherson Thompson
• Warren N. Thompson, MENTAL HEALTH THERAP
• William Calhoun Thompson II
• Sara Woodby Thornburg, PT, DPT
• Kayde Thrams, PA-C
• Anna Thrift, MED, CCC-SLP
• William Tillett, PHARMD
• Tim's Home Medical of Brunswick, Inc

• General Practice Dentistry in Brunswick, GA
• Providers in Brunswick, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.