=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366383390
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID E THOME DDS PLLC L1
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2026
-----------------------------------------------------
Last Update Date | 04/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7856 VILLAGE CTR N STE 200
-----------------------------------------------------
City | SHERRILLS FORD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28673-9413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-750-8320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7856 VILLAGE CTR N STE 200
-----------------------------------------------------
City | SHERRILLS FORD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28673-9413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-750-8320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PAYOR RELATIONS & CRED
-----------------------------------------------------
Name | SONYA MYRICK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 980-390-2807
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------