1609873892 NPI number — DR. WILLIAM KNOERR THOMPSON DDS

Table of content: DR. WILLIAM KNOERR THOMPSON DDS (NPI 1609873892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609873892 NPI number — DR. WILLIAM KNOERR THOMPSON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMPSON
Provider First Name:
WILLIAM
Provider Middle Name:
KNOERR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMPSON
Provider Other First Name:
WILLIAM
Provider Other Middle Name:
KNOERR
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1609873892
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/15/2006
NPI Reactivation Date:
03/28/2006

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9475 BRIAR VILLAGE PT
Provider Second Line Business Mailing Address:
STE 115
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80920-7902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-268-9400
Provider Business Mailing Address Fax Number:
719-268-9403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9475 BRIAR VILLAGE PT
Provider Second Line Business Practice Location Address:
STE 115
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80920-7902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-268-9400
Provider Business Practice Location Address Fax Number:
719-268-9403
Provider Enumeration Date:
07/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  7811 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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