MEDICARE: DAVID E THOME DDS PLLC VIII

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	9277	NC

General Provider Information

NPI Number	:	1619418076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID E THOME DDS PLLC VIII

Provider Business Mailing Address
First Line	:	236 MARKET ST STE 200
Second Line	:
City	:	LOCUST
State	:	NC
Zip	:	28097-9439
Country	:	US
Telephone Number	:	980-354-0784
Fax Number	:

Provider Business Practice Location Address
First Line	:	236 MARKET ST
Second Line	:	SUITE 200
City	:	LOCUST
State	:	NC
Zip	:	28097-9438
Country	:	US
Telephone Number	:	704-604-0353
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING & PAYER R
Name	:	SONYA MYRICK
Credential	:
Telephone Number	:	980-390-2807

Provider Enumeration Date	:	03/17/2017
Last Update Date	:	10/27/2025

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