Healthcare Provider Details

I. General information

NPI: 1194702332
Provider Name (Legal Business Name): ANTHONY STERLING THOMAS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9409 SHERIDAN BLVD
WESTMINSTER CO
80031-6532
US

IV. Provider business mailing address

577 STERNBERG AVE
FORT EUSTIS VA
23604-1526
US

V. Phone/Fax

Practice location:
  • Phone: 303-305-4062
  • Fax:
Mailing address:
  • Phone: 757-314-7944
  • Fax: 757-314-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE00009431
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401008859
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number003922
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number00202208
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDEN.00202208
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: