Individual provider Active NPI

Alana Kvichak Thompson, D.D.S.

  • General Practice Dentistry
  • Santa Cruz, CA
National Provider Identifier
1861402406
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52631 Issued in CA
Practice address
1830 Commercial Way
Santa Cruz, CA 95065-1819
Phone
(831) 464-5422
Fax
(831) 464-5415
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 52631 CA Primary

Addresses

Primary practice location

1830 Commercial Way
Santa Cruz, CA 95065-1819

Mailing address

1830 Commercial Way
Santa Cruz, CA 95065-1819
Phone (831) 464-5422

Other identifiers 1

IdentifierTypeStateIssuer
D52631MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160408000098 CA Order and Referring Only - DentistPractitioner - Dentist 1254639222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249430400000",
    "number": "1861402406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5422",
            "fax_number": "831-464-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5422",
            "fax_number": "831-464-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ALANA",
        "middle_name": "KVICHAK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D52631",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.