Active NPI
Jonathon B Thomson, DMD
- General Practice Dentistry
- Wickenburg, AZ
National Provider Identifier
1629636667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D011701
- Practice address
- 1175 W Wickenburg Way
Suite 1
Wickenburg, AZ 85390-2262 - Phone
- (928) 684-1145
- NPI assigned
- Jun 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02769501 | NJ | |
| General Practice Dentistry | 1223G0001X | D011701 | AZ | Primary |
Addresses
Primary practice location
1175 W Wickenburg Way
Suite 1
Wickenburg, AZ 85390-2262
Mailing address
1175 W Wickenburg Way
Suite 1
Wickenburg, AZ 85390-2262
Phone (928) 684-1145
Other practice location 1
3069 English Creek Ave Ste 304
Egg Harbor Township, NJ 08234
Phone (609) 645-1900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02769501 | NJ | MD | Dentist |
| D011701 | AZ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J & J Smiles | Current | Accepting new patients | |
| Atlantic Smiles LLC | Past | Accepting new patients |
Locations
1175 W Wickenburg Way
Ste 1
Wickenburg, AZ 85390
Phone (623) 217-2948
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Wickenburg, AZ
- NPI 1699463497
-
- Dental Clinic/Center
- Egg Harbor Township, NJ
- NPI 1023273695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1629636667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 W WICKENBURG WAY",
"address_2": "SUITE 1",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853902262",
"telephone_number": "928-684-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 W WICKENBURG WAY",
"address_2": "SUITE 1",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853902262",
"telephone_number": "928-684-1145"
}
],
"practiceLocations": [
{
"address_1": "3069 English Creek Ave Ste 304",
"address_purpose": "LOCATION",
"city": "Egg Harbor Township",
"state": "NJ",
"postal_code": "08234",
"country_code": "US",
"telephone_number": "609-645-1900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMSON",
"first_name": "JONATHON",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-04",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02769501",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D011701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wickenburg, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.