Individual provider Active NPI

Jonathon B Thomson, DMD

  • General Practice Dentistry
  • Wickenburg, AZ
National Provider Identifier
1629636667
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011701 Issued in AZ
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

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
22DI02769501NJMDDentist
D011701AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
J & J Smiles CurrentSince Jul 2, 2023 Accepting new patients
Atlantic Smiles LLC PastSince Aug 1, 2019 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.

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.

Verify at the official NPI Registry.