Individual provider Active NPI

Thomas Clayton Turner III, DDS

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1902916786
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4892 Issued in AZ
Practice address
3740 E Southern Ave Ste 124
Mesa, AZ 85206-2568
Phone
(480) 633-7807
Fax
(480) 633-0647
NPI assigned
Aug 30, 2006
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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 4892 AZ Primary

Addresses

Primary practice location

3740 E Southern Ave Ste 124
Mesa, AZ 85206-2568

Mailing address

3740 E Southern Ave Ste 124
Mesa, AZ 85206-2568
Phone (480) 633-7807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150708003031 AZ Order and Referring Only - DentistPractitioner - Dentist 1456663103

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1902916786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 124",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062568",
            "telephone_number": "480-633-7807",
            "fax_number": "480-633-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 124",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062568",
            "telephone_number": "480-633-7807",
            "fax_number": "480-633-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNER",
        "first_name": "THOMAS",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "4892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.