Kevin George Thomas, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2017017287 Issued in MO

Practice address

1101 N Providence Rd
Columbia, MO 65203-4365

Phone

(573) 886-6741

NPI assigned

Jul 12, 2017

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

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.

• Aria Dental Care PC

  • Dentist
  • Overland Park, KS
  • NPI 1942977632

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1720500655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PARKWAY",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63146",
            "telephone_number": "314-872-1439",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N PROVIDENCE RD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034365",
            "telephone_number": "573-886-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KEVIN",
        "middle_name": "GEORGE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2017017287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI DENTAL LICENSE",
            "identifier": "2017017287",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blake Reagan Thomas, LCSW
• David Thomas, FNP
• David R Thomas, LCSW
• Ellen H Thomas, MD.
• Jonathan L Thomas, M.D.
• Kevin Mathew Thomas
• Lisa Ann Thomas, M.D.
• Marwa Taranissi Thomas, MD
• Matthew Thomas, M.D.
• Megan L Thomas, DDS

• Dentist in Columbia, MO
• Providers in Columbia, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.