Individual provider Active NPI

John Daniel Thomas Jr., DDS

  • General Practice Dentistry
  • Cordova, TN
National Provider Identifier
1699796995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS4155 Issued in TN
Practice address
278 German Oak Dr
Cordova, TN 38018-7220
Phone
(901) 753-9005
Fax
(901) 753-0760
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DS4155 TN Primary

Addresses

Primary practice location

278 German Oak Dr
Cordova, TN 38018-7220

Mailing address

278 German Oak Dr
Cordova, TN 38018-7220
Phone (901) 753-9005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160419002418 TN Order and Referring Only - Other (Non-Physician) 0648578963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699796995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 GERMAN OAK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187220",
            "telephone_number": "901-753-9005",
            "fax_number": "901-753-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 GERMAN OAK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187220",
            "telephone_number": "901-753-9005",
            "fax_number": "901-753-0760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "JOHN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS4155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.