Jesse Craig Thompson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4915094-9921 Issued in UT

Practice address

4TH and Inner Loop BLDG 171
Fort Irwin, CA 92310

Phone

(760) 380-9201

NPI assigned

Jun 6, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1871931394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 CARROLL RD",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4TH AND INNER LOOP BLDG 171",
            "city": "FORT IRWIN",
            "state": "CA",
            "postal_code": "92310",
            "telephone_number": "760-380-9201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Caserma Ederle Bldg 2310",
            "address_purpose": "LOCATION",
            "city": "Vicenza",
            "state": "Veneto",
            "postal_code": "36100",
            "country_code": "IT",
            "telephone_number": "390444619000 x2",
            "country_name": "Italy",
            "address_type": "FGN"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JESSE",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2023-04-05",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9308",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "4915094-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tafaogalupe Swanney, DENTAL ASSISTANT
• George Stanley Szworc-Betran, RN
• Clifton Edward Tavares, BSN, RN
• Jacqueline Taylor, LCSW
• Kristen A. Tharp, R.N.
• Jordan H.Q. Tran, DMD
• Ashonda T-Kay Trice, RN
• Nhat Truong
• Marisa Uptmor, DPT
• US Army Nursing Corp

• Orthodontics and Dentofacial Orthopedics Dentistry in Fort Irwin, CA
• Providers in Fort Irwin, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.