Provider Demographics
NPI:1578645701
Name:JAMES S. THOMPSON, DDS, PA
Entity Type:Organization
Organization Name:JAMES S. THOMPSON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-765-9002
Mailing Address - Street 1:598 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-2728
Mailing Address - Country:US
Mailing Address - Phone:828-765-9002
Mailing Address - Fax:828-765-1614
Practice Address - Street 1:598 OAK AVE
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-2728
Practice Address - Country:US
Practice Address - Phone:828-765-9002
Practice Address - Fax:828-765-1614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014T6Medicaid