MEDICARE: DR. SANDRA THOMPSON DMD

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	S6-129	NV

General Provider Information

NPI Number	:	1740542224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA THOMPSON DMD

Provider Business Mailing Address
First Line	:	9859 W DEER SPRINGS WAY STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1447
Country	:	US
Telephone Number	:	702-660-7099
Fax Number	:

Provider Business Practice Location Address
First Line	:	9859 W DEER SPRINGS WAY STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-1447
Country	:	US
Telephone Number	:	702-660-7099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	09/08/2025

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