Individual provider Active NPI

Edwin Michael Thomas. Jr., D.D.S.

  • Endodontics
  • Abington, MA
National Provider Identifier
1891894978
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
14400 Issued in MA
Practice address
477 Washington St
Abington, MA 02351-2417
Phone
(781) 878-2190
Fax
(781) 878-3011
NPI assigned
Sep 22, 2006
Last updated
Apr 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 14400 MA Primary

Addresses

Primary practice location

477 Washington St
Abington, MA 02351-2417

Mailing address

477 Washington St
P.O. Box 2049
Abington, MA 02351-2417
Phone (781) 878-2190

Other identifiers 1

IdentifierTypeStateIssuer
043090133OtherMATAX ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150520000995 MA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2961722632

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14400MAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
42 North Dental Care, LLC Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1891894978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 WASHINGTON ST",
            "address_2": "P.O. BOX 2049",
            "city": "ABINGTON",
            "state": "MA",
            "postal_code": "023512417",
            "telephone_number": "781-878-2190",
            "fax_number": "781-878-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 WASHINGTON ST",
            "city": "ABINGTON",
            "state": "MA",
            "postal_code": "023512417",
            "telephone_number": "781-878-2190",
            "fax_number": "781-878-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS.",
        "first_name": "EDWIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "14400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "043090133",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abington, MA

Sources for this page

Verify at the official NPI Registry.