KELLY R. THOMAS (NPI# 1508068347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508068347 |
| Entity Type | Individual |
| Full Name | KELLY R. THOMAS |
| Credential | D.M.D |
| Practice Address |
12575 Sw 3rd St Beaverton OR 97005-0517 |
| Practice Telephone | 5036447697 |
| Mailing Telephone | 5036447697 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D6393 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144782970 | Kelly L Thomas | Pediatrics | 10011 Ink Wells Dr, San Antonio, TX 78250-7011 | 2019-04-01 |
| 1295217909 | Kelly Thomas | Counselor | 293 Wilson St Fl 3, Manchester, NH 03103-5021 | 2018-08-30 |
| 1831448430 | Kelly Marie Thomas | Clinic/Center | 4877 Mission Street, San Francisco, CA 94112 | 2012-08-29 |
| 1942573324 | Kelly Ann Thomas | Health Educator | 2203 Alvin Ave, Baltimore, MD 21228-4731 | 2012-02-16 |
| 1275838302 | Kelly Marie Thomas | Nurse Practitioner | 300 Keisler Dr Ste 204, Cary, NC 27518-7083 | 2011-01-21 |
| 1194952440 | Kelly Elizabeth Thomas | Speech-Language Pathologist | 1106 E Santa Clara St, Ventura, CA 93001-3177 | 2009-06-14 |
| 1932334471 | Kelly Chirstine Thomas | Massage Therapist | 4430 Tropical Dr, Panama City, FL 32404-5201 | 2009-05-28 |
| 1356509111 | Kelly Thomas | Speech-Language Pathologist | 2811 W Huntsville Ave, Springdale, AR 72762-7736 | 2008-05-29 |
| 1790973196 | Kelly Latreece Thomas | Internal Medicine | 526 Kingwood Dr # 113, Kingwood, TX 77339-4473 | 2007-10-10 |
| 1134761042 | Kelly Thomas | Nurse Practitioner | 2540 16th St, Port Huron, MI 48060-6405 | 2019-10-11 |
| Street Address |
12575 SW 3RD ST |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-0517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942510458 | Mazyar Afshar | Dentist | 12575 Sw 3rd St, Beaverton, OR 97005-0517 | 2010-10-18 |
| 1447589452 | Thomas Family Dentistry | Clinic/Center | 12575 Sw 3rd St, Beaverton, OR 97005-0517 | 2009-12-22 |
| 1114252970 | Audrey Beth Milam | Dental Hygienist | 12575 Sw 3rd St, Beaverton, OR 97005-0517 | 2009-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1235662131 | Mishaun Sahebi | Dentist | 10320 Sw Mockingbird Way, Beaverton, OR 97007-6176 | 2017-04-07 |
| 1114478971 | Jun Hyug Choi | Dentist | 5055 Sw 160th Ave, Beaverton, OR 97007-2614 | 2016-10-17 |
| 1760727234 | Madugula LLC | Dentist | 2235 Nw Town Center Dr, Beaverton, OR 97006 | 2012-12-10 |
| 1821348889 | Aaron Lloyd Pogue | Dentist | 17203 Sw Baseline Rd, Beaverton, OR 97006-4253 | 2012-09-17 |
| 1295083111 | Carolyn Choi | Dentist | 12600 Sw Crescent St Ste 106, Beaverton, OR 97005 | 2012-08-27 |
| 1134439144 | Mira Kharoti Della Croce | Dentist | 1791 Nw 173rd Ave Ste 110, Beaverton, OR 97006-5630 | 2010-10-13 |
| 1205145489 | Joshua Kim | Dentist | 10773 Sw Beaverton Hillsdale Hwy Ste B, Beaverton, OR 97005-3010 | 2010-10-05 |
| 1528377546 | John Neil Della Croce | Dentist | 8070 Sw Hall Blvd Ste 200, Beaverton, OR 97008-6419 | 2010-09-27 |
| 1306150768 | Christopher L Flemming | Dentist | 4925 Sw Griffith Drive, Beaverton, OR 97005-0000 | 2010-07-27 |
| Find all providers in BEAVERTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.