Active NPI
Marcus Andrew Thayn, DDS
- General Practice Dentistry
- San Diego, CA
National Provider Identifier
1992221659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-4853
- Practice address
- 43000 Midway Ave BLDG 595
San Diego, CA 92140-5692 - Phone
- (619) 524-4009
- NPI assigned
- Aug 15, 2017
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4853 | ID | Primary |
Addresses
Primary practice location
43000 Midway Ave BLDG 595
San Diego, CA 92140-5692
Mailing address
Naval Medical Center
34800 Bob Wilson Drive
San Diego, CA 92134-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VADOOOO | Other | MILITARY PHYSICIANS |
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 |
|---|---|---|---|
| D-4853 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502755200000",
"number": "1992221659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL MEDICAL CENTER",
"address_2": "34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921345000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43000 MIDWAY AVE BLDG 595",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921405692",
"telephone_number": "619-524-4009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAYN",
"first_name": "MARCUS",
"middle_name": "ANDREW",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-15",
"last_updated": "2017-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4853",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILITARY PHYSICIANS",
"identifier": "VADOOOO",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.