Sunil Dev Thanik, DMD MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D7848 Issued in OR

Practice address

12025 SW 70TH Ave
Tigard, OR 97223-9634

Phone

(503) 924-6505

Fax

(503) 924-6507

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sunil D. Thanik, DMD, MSD, LLC

  dba Progressive Periodontics

  • Periodontics
  • Tigard, OR
  • NPI 1972354447
  NPD

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1649250317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 SW 70TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239634",
            "telephone_number": "503-924-6505",
            "fax_number": "503-924-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 SW 70TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972239634",
            "telephone_number": "503-924-6505",
            "fax_number": "503-924-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANIK",
        "first_name": "SUNIL",
        "middle_name": "DEV",
        "name_prefix": "Dr.",
        "credential": "DMD MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D7848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Caitlyn Nicole Teters
• Phuong Anh Tran Thai
• The Embodied Wellness Studio LLC
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• The Neuro Wellness Collective
• The Psychotherapy Associates of Oregon
• The Way of Health

• Periodontics in Tigard, OR
• Providers in Tigard, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.