Thomas C. Backenstose Jr., DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

D10848 Issued in MN

Practice address

7 N Columbus Blvd Apt 238
Philadelphia, PA 19106-1421

Phone

(612) 802-4697

Fax

(215) 583-5222

NPI assigned

Nov 29, 2005

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

Enrolled in PA

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

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1760465272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 N COLUMBUS BLVD APT 238",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061421",
            "telephone_number": "612-802-4697",
            "fax_number": "215-583-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 N COLUMBUS BLVD APT 238",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191061421",
            "telephone_number": "612-802-4697",
            "fax_number": "215-583-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKENSTOSE",
        "first_name": "THOMAS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-08-24",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MN",
            "license": "D10848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Back Office Management Services LLC
• Back Strategies, Inc
• Amanda Back, MS, CGC
• O'Shane J Back
• Susan J Back, M.D.
• Claire R Backenstow
• Deborah E Backiel, DMD
• Kimberly A Backstrom, DPT
• Derrick Bacon
• Karey Anna Bacon, PMHNP, BSN, RN

• All providers in Philadelphia, PA
• Prosthodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; 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.