Craig C. Thiede DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

CRAIG C. THIEDE DDS

Practice address

13132 Newport Ave Ste 230
Tustin, CA 92780-3429

Phone

(714) 730-6767

Fax

(714) 730-1161

NPI assigned

Nov 11, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Craig Thiede

Title

Office Manager

Phone

(714) 730-6767

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1841892148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13132 NEWPORT AVE STE 230",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803429",
            "telephone_number": "714-730-6767",
            "fax_number": "714-730-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13132 NEWPORT AVE STE 230",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803429",
            "telephone_number": "714-730-6767",
            "fax_number": "714-730-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG C. THIEDE DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-11",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "THIEDE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-730-6767",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Tustin, CA
• Providers in Tustin, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.