Provider Demographics
NPI:1326008160
Name:STEVEN L. THOMPSON, DDS, P.A.
Entity Type:Organization
Organization Name:STEVEN L. THOMPSON, DDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-242-5753
Mailing Address - Street 1:1334 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:KS
Mailing Address - Zip Code:66067-3527
Mailing Address - Country:US
Mailing Address - Phone:785-242-5753
Mailing Address - Fax:785-242-8359
Practice Address - Street 1:1334 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3527
Practice Address - Country:US
Practice Address - Phone:785-242-5753
Practice Address - Fax:785-242-8359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO08137010OtherBLUE CROSS BLUE SHIELD
KS116806OtherBLUE CROSS BLUE SHIELD
KS116806OtherBLUE CROSS BLUE SHIELD