Healthcare Provider Details

I. General information

NPI: 1528999844
Provider Name (Legal Business Name): JAY THOMAS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 TURNER ST # B
ABERDEEN NC
28315-2363
US

IV. Provider business mailing address

292 TURNER ST # B
ABERDEEN NC
28315-2363
US

V. Phone/Fax

Practice location:
  • Phone: 910-807-0071
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14709
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: