Daniel Heiner Thunell, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

30206 Issued in IA

Practice address

4252 South Highland Dr.
Salt Lake City, UT 84124

Phone

(801) 272-4867

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 17, 2019 through Jul 17, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Alpen Implants and Periodontics Specialists LLC

  • Periodontics
  • Lehi, UT
  • NPI 1871253328
  NPD Authorized official
• Wasatch Periodontal Specialists LLC

  • Periodontics
  • Salt Lake City, UT
  • NPI 1962162412
  NPD Authorized official

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1962615948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4252 SOUTH HIGHLAND DR.",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-272-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4252 SOUTH HIGHLAND DR.",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "801-272-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUNELL",
        "first_name": "DANIEL",
        "middle_name": "HEINER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IA",
            "license": "30206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrivewave LLC
• Steven Kyle Throneberry, M.D.
• John Darrell Thueson, M.D.
• Justin F Thulin, MD
• Perla Cassayre Thulin, MD
• Abbie Ranae Thurgood, CSW
• Randy F Thurgood
• Tian Tian
• Whitney Ann Tiatia
• Mary Tibbitts

• Periodontics in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.