Organization Active NPI

Thomasville Dental Center

  • General Practice Dentistry
  • Thomasville, GA
National Provider Identifier
1861041113
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
THOMASVILLE DENTAL CENTER
Practice address
396 Liberty Street
Thomasville, GA 31757-4822
Phone
(229) 227-9070
Fax
(229) 227-6299
NPI assigned
Sep 10, 2019
Last updated
Sep 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
Beverly Leanne Burthold
Title
Office Manager
Phone
(229) 227-9070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

396 Liberty Street
Thomasville, GA 31757-4822

Mailing address

396 Liberty Street
Thomasville, GA 31757-4822
Phone (229) 227-9070

National Provider Directory

National Provider Directory
Tax ID family
Thomasville Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

396 Liberty St
Thomasville, GA 31757
Phone (229) 227-9070

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1861041113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 LIBERTY STREET",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574822",
            "telephone_number": "229-227-9070",
            "fax_number": "229-227-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 LIBERTY STREET",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574822",
            "telephone_number": "229-227-9070",
            "fax_number": "229-227-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "BURTHOLD",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "LEANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "229-227-9070"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.