Active NPI
Alfred Addison Thresher III, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Las Vegas, NV
National Provider Identifier
1952476285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- S3-56
- Practice address
- 9500 W Flamingo Rd Ste 102
Las Vegas, NV 89147-5720 - Phone
- (702) 254-4335
- Fax
- (702) 254-7995
- NPI assigned
- Nov 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | S3-56 | NV | Primary |
Addresses
Primary practice location
9500 W Flamingo Rd Ste 102
Las Vegas, NV 89147-5720
Mailing address
9500 W Flamingo Rd Ste 102
Las Vegas, NV 89147-5720
Phone (702) 254-4335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100511177 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3-56 | NV | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1952476285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 W FLAMINGO RD STE 102",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891475720",
"telephone_number": "702-254-4335",
"fax_number": "702-254-7995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 W FLAMINGO RD STE 102",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891475720",
"telephone_number": "702-254-4335",
"fax_number": "702-254-7995"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THRESHER",
"first_name": "ALFRED",
"middle_name": "ADDISON",
"name_suffix": "III",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NV",
"license": "S3-56",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100511177",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.