Provider Demographics
NPI:1598898876
Name:PINCKNEY, THOMAS WATKINS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WATKINS
Last Name:PINCKNEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 VALLEY WEST DRIVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9998
Mailing Address - Country:US
Mailing Address - Phone:515-222-0656
Mailing Address - Fax:
Practice Address - Street 1:1200 VALLEY WEST DRIVE
Practice Address - Street 2:SUITE 401
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-9998
Practice Address - Country:US
Practice Address - Phone:515-222-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA62II1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
0148015Medicare UPIN