Individual provider Active NPI

Walter L Thomas, DDS

  • General Practice Dentistry
  • Madison, WI
National Provider Identifier
1649378217
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6026-15 Issued in WI
Practice address
3434 E. Washington Ave.
Madison, WI 53704-4155
Phone
(608) 443-5550
Fax
(608) 443-5570
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6026-15 WI Primary

Addresses

Primary practice location

3434 E. Washington Ave.
Madison, WI 53704-4155

Mailing address

2901 W Beltline Hwy
Ste. 120
Madison, WI 53713-4226
Phone (608) 443-5500

Other identifiers 1

IdentifierTypeStateIssuer
33801300MedicaidWI

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
I20160104001855 WI Order and Referring Only - DentistPractitioner - Dentist 4880799246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates LTD of Wisconsin General Practice PastSince Feb 14, 2016 Accepting new patients

Organizations & group practices 1

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334016000000",
    "number": "1649378217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 W BELTLINE HWY",
            "address_2": "STE. 120",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537134226",
            "telephone_number": "608-443-5500",
            "fax_number": "608-441-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 E. WASHINGTON AVE.",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044155",
            "telephone_number": "608-443-5550",
            "fax_number": "608-443-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "WALTER",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6026-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33801300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.