Kenneth D Thompson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47812 Issued in CA

Practice address

4213 Dale Rd.
Suite 5
Modesto, CA 95356

Phone

(209) 545-4760

Fax

(209) 545-2166

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kenneth D Thompson DDS Inc

  • General Practice Dentistry
  • Modesto, CA
  • NPI 1194962852
  NPD (past) Authorized official

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689788598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 DALE RD",
            "address_2": "SUITE 5",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568505",
            "telephone_number": "209-545-4760",
            "fax_number": "209-545-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4213 DALE RD.",
            "address_2": "SUITE 5",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95356",
            "telephone_number": "209-545-4760",
            "fax_number": "209-545-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KENNETH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hillary Ruth Ann Thompson, CMT
• James I Thompson, DO
• Jeanette Thompson
• Joseph Thompson
• Julia Ann Thompson
• Michael Shane Thompson, RAS, CDAC
• Rachel Grace Thompson
• Rhonda Michelle Thompson, COTA
• Robert Carl Thompson
• Shelby Adrienne Thompson, RDA OMSA

• General Practice Dentistry in Modesto, CA
• Providers in Modesto, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.