Individual provider Active NPI

Craig Joseph Thomas, DDS

  • Dentist
  • Elkhorn, WI
National Provider Identifier
1609076884
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
WI 4536 Issued in WI
Practice address
300 S Lincoln St
Elkhorn, WI 53121-1814
Phone
(262) 723-3296
Fax
(262) 723-2556
NPI assigned
Jul 24, 2007
Last updated
Jul 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X WI 4536 WI Primary

Addresses

Primary practice location

300 S Lincoln St
Elkhorn, WI 53121-1814

Mailing address

300 S Lincoln St
Elkhorn, WI 53121-1814
Phone (262) 723-3296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150126002104 WI Order and Referring Only - DentistPractitioner - Dentist 7911221742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI 4536WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1609076884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S LINCOLN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211814",
            "telephone_number": "262-723-3296",
            "fax_number": "262-723-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S LINCOLN ST",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211814",
            "telephone_number": "262-723-3296",
            "fax_number": "262-723-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CRAIG",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "WI 4536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

Verify at the official NPI Registry.