Thomas M Dewerd DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

D9357 Issued in MN

Legal business name

THOMAS M DEWERD DDS PA

Practice address

3359 W Broadway Ave
Robbinsdale, MN 55422-2928

Phone

(763) 522-4451

Fax

(763) 522-2464

NPI assigned

Oct 31, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Michael Dewerd, DDS

Title

President

Phone

(763) 522-4451

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922099845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222928",
            "telephone_number": "763-522-4451",
            "fax_number": "763-522-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 W BROADWAY AVE",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222928",
            "telephone_number": "763-522-4451",
            "fax_number": "763-522-2464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS M DEWERD DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEWERD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-522-4451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Home Care)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Specialty Care Community)
• The Evangelical Lutheran Good Samaritan Society (Robbinsdale Good Samaritan Center)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society- Home Care)
• Christopher Nicholas Thein, MS, ATC, EMT
• Merrill Thomas, M.D.
• Patina Thomas, LPCC, LADC
• Rebecca R Thomas, MD
• Maryann Thompson
• Tara M Thompson, CRNA

• Dentist in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.