Thomas John Allen, DMD
Individual provider Active NPI Dentist · Tuba City, AZ
NPI 1992012132 · NPPES record last updated Jun 6, 2011
Key facts
- NPI
- 1992012132
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D9496 (OR)
- Practice address
- 167 North Main Street
Tuba City, AZ 86045-0600 - Phone
- (928) 283-2501
- NPI assigned
- Sep 9, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101109001161 | TX | Practitioner - Oral Surgery | 1658566294 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaska Native Tribal Health Consortium | Current | Accepting new patients | |
| Tuba City Regional Health Care Corporation | Current | Accepting new patients | |
| Tuba City Regional Health Care Corporation | Dentist | Current |
Accepting new patients |
| Tuba City Regional Health Care Corporation | Current |
Accepting new patients |
Interoperability endpoints
- tallen@direct.scf.cc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9496 | OR | Yes |
Addresses
Primary practice location
167 North Main Street
Tuba City, AZ 86045-0600
Mailing address
3008 E. Birch Ave
Tuba City, AZ 86045-0600
Phone (928) 283-2501
Other providers in Tuba City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.