Thane Hepworth, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D4717 Issued in ID

Practice address

3 E Center St
Sugar City, ID 83448-1247

Phone

(208) 656-2000

Fax

(208) 464-9002

NPI assigned

Jul 1, 2014

Last updated

Jul 29, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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 ID

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

Practice roles

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.

• Stone Ridge Sugar City Dba Stone Ridge Dental

  • Dental Clinic/Center
  • Sugar City, ID
  • NPI 1881045698
  NPD (past)

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1902211733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57",
            "city": "SUGAR CITY",
            "state": "ID",
            "postal_code": "834480057",
            "telephone_number": "208-656-2000",
            "fax_number": "208-464-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 E CENTER ST",
            "city": "SUGAR CITY",
            "state": "ID",
            "postal_code": "834481247",
            "telephone_number": "208-656-2000",
            "fax_number": "208-464-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEPWORTH",
        "first_name": "THANE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D4717",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D1059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreasen Physical Therapy PC
• Samantha Arnold, LCSW
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• Ellon Chase, LPC
• Tonya Hollist, LCSW
• Douglas J Messick, DDS
• Julie Lynn Moss
• Victoria Marie Searle, FNP-C
• Stone Ridge Sugar City Dba Stone Ridge Dental

• Dentist in Sugar City, ID
• Providers in Sugar City, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.