Alice Louise Whitehair Thomas, DDS
Individual provider Active NPI General Practice Dentistry · Montpelier, IN
NPI 1770916207 · NPPES record last updated Dec 22, 2020
Key facts
- NPI
- 1770916207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12012685A (IN)
- Practice address
- 108 N Main St
Montpelier, IN 47359-1132 - Phone
- (765) 728-2811
- NPI assigned
- Aug 20, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240311001037 | IN | Practitioner - Dentist | 9931545118 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6051 | AL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Door Health Services, Inc. | Current |
Accepting new patients | |
| Open Door Health Services, Inc. | Current |
Accepting new patients | |
| Open Door Health Services, Inc. | Current | Accepting new patients | |
| Foley Family Dentistry | Dentist | Past | Accepting new patients |
| Open Door Health Services, Inc. | Past | Accepting new patients | |
| Open Door Health Services, Inc. | Past | Accepting new patients | |
| Montpelier Family Dentistry LLC | Past |
Accepting new patients | |
| Open Door Health Services, Inc. | Past | Accepting new patients |
Locations
333 S Madison St
Muncie, IN 47305
Phone (765) 287-3087
333 S Madison St
Ste A
Muncie, IN 47305
Interoperability endpoints
- alice.whitehair-thomas.1@10844.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6051 | AL | |
| General Practice Dentistry | 1223G0001X | 12012685A | IN | Yes |
Addresses
Primary practice location
108 N Main St
Montpelier, IN 47359-1132
Mailing address
108 N Main St
Montpelier, IN 47359-1132
Phone (765) 728-2811
Other providers in Montpelier, IN
- Richard G Ingram, MD, Inc
- S & K Care Company LLC
- S & K Care Company LLC
- Lori J Skidmore
- Milus Ralph Skidmore
All providers in Montpelier, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.