Provider Demographics
NPI:1710037957
Name:THOMAS, DARREN (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:8481 VIRGINIA DR.
Mailing Address - City:WESTFIELD CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:44251
Mailing Address - Country:US
Mailing Address - Phone:330-887-1777
Mailing Address - Fax:330-948-1039
Practice Address - Street 1:8481 VIRGINIA DR.
Practice Address - Street 2:
Practice Address - City:WESTFIELD CENTER
Practice Address - State:OH
Practice Address - Zip Code:44251
Practice Address - Country:US
Practice Address - Phone:330-887-1777
Practice Address - Fax:330-948-1039
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200801223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice