Gregory M Thackston, DMD,Magd,LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9888 Issued in GA

Legal business name

GREGORY M THACKSTON, DMD,MAGD,LLC

Practice address

506 Madison Ave N
Douglas, GA 31533-4616

Phone

(912) 384-7200

Fax

(912) 384-0885

NPI assigned

Mar 17, 2008

Last updated

Mar 17, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Darilyn Thackston

Title

Office Manager

Phone

(912) 384-7200

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory M Thackston, DMD

  • General Practice Dentistry
  • Douglas, GA
  • NPI 1134147242
  NPD (past)

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1811168909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1150",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341150",
            "telephone_number": "912-384-7200",
            "fax_number": "912-384-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MADISON AVE N",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315334616",
            "telephone_number": "912-384-7200",
            "fax_number": "912-384-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M THACKSTON, DMD,MAGD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "THACKSTON",
        "authorized_official_first_name": "DARILYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-384-7200"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Markita Monique Goodwin
• Gracious Companions LLC
• Karen T. Graves, CAC-2
• Princess Graves
• Karen Michelle Green, PA
• Kiplyn Griffin, SLP
• Kristi Rebecca Gross, CST, CSFA
• Guy W. Moorman, Jr. DDS. PC
• Jessical Hall, M.ED CCC-SLP
• Julie Johnson Hall, FNP-C

• General Practice Dentistry in Douglas, GA
• Providers in Douglas, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.