Individual provider Active NPI

Kristi Andrette Thomas, DDS

  • Dentist
  • Detroit, MI
National Provider Identifier
1881771749
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901017876 Issued in MI
Practice address
7310 Woodward Ave Ste 400
Detroit, MI 48202-3165
Phone
(313) 733-1176
NPI assigned
Oct 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901017876 MI Primary

Addresses

Primary practice location

7310 Woodward Ave Ste 400
Detroit, MI 48202-3165

Mailing address

7310 Woodward Ave Ste 400
Detroit, MI 48202-3165
Phone (313) 733-1176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20121108000350 MI Practitioner - Oral Surgery 6406007053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017876MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Plan Medical Centers CurrentSince Oct 8, 2012 Accepting new patients
The Wellness Plan Medical Centers CurrentSince Oct 8, 2012 Accepting new patients

Locations

2888 W Grand Blvd
Detroit, MI 48202
Phone (313) 875-4200

4909 E Outer Dr
Detroit, MI 48234
Phone (313) 366-2000

21040 Greenfield Rd
Oak Park, MI 48237
Phone (248) 967-1888

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCBDCD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1881771749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 WOODWARD AVE STE 400",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023165",
            "telephone_number": "313-733-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7310 WOODWARD AVE STE 400",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023165",
            "telephone_number": "313-733-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KRISTI",
        "middle_name": "ANDRETTE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.