DR. MATTHEW JOHN THACKER (NPI# 1427544659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427544659 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW JOHN THACKER |
| Credential | DMD |
| Practice Address |
1591 Griffin Rd. Twentynine Palms CA 92278 |
| Mailing Address |
9465 W Post Rd Apt 2055 Las Vegas NV 89148-5792 |
| Practice Telephone | 7608307054 |
| Mailing Telephone | 7024087224 |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 7102 | NV | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235449471 | Matthew Thacker | Chiropractor | 437 Springfield St, Park Forest, IL 60466-1052 | 2010-10-20 |
| Street Address |
1591 GRIFFIN RD. |
| City | TWENTYNINE PALMS |
| State | CA |
| Zip Code | 92278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770143711 | Michelle Alexandra Engel | Student in an Organized Health Care Education/Training Program | Twentynine Palms Marine Base, 1591, Apo, AA 92278 | 2019-06-20 |
| 1922541986 | Joshua Gumpert | Physician Assistant | 1560 6th St, 2nd Deck, Twentynine Palms, CA 92278 | 2016-11-23 |
| 1427441112 | Joshua Bellavia | Military Health Care Provider | Commanding Officer Naval Hospital Twentynine Palms, Attn: Joshua Bellavia Box 788250, Twentynine Palms, CA 92278 | 2015-03-05 |
| 1730583063 | Erric Leif Apeland | Military Health Care Provider | 1436 Third Street, Mcagcc, Twentynine Palms, CA 92278 | 2014-10-15 |
| 1609286137 | Jason Ulaner | Chiropractor | 1145 Sturgis St, Twentynine Palms, CA 92278 | 2014-05-06 |
| 1497184188 | Blake Lyman | Physician Assistant | 1552 6th Street, Adult Medical Care Clinic, Twentynine Palms, CA 92278 | 2013-11-04 |
| 1013267996 | Alonzo Jamelle Shields | Military Health Care Provider | Regimental Aid Station, 7th Marine Hq Ras, Twentynine Palms, CA 92278 | 2012-09-18 |
| 1184996134 | William John Becker | Physician Assistant | Mcagcc, Building 1538, Twnetynine Palms, CA 92278 | 2012-02-07 |
| 1962666776 | Michael D Vanmanen | Orthopaedic Surgery | Bldg 1145 Sturgis Rd, Twentynine Palms, CA 92278 | 2008-07-11 |
| 1427235233 | Marion Henry | Surgery | Sturgis Ave and 1st Street, Marine Corps Air Ground Combat Center, Twentynine Palms, CA 92278 | 2008-01-23 |
| Find all providers in zip 92278 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699737 | William Bill Ngo | Dentist | 1591 Griffin Road Mcagcc, Twentynine Palms, CA 92277 | 2020-11-06 |
| 1093283202 | James Degracie | Dentist | 1519 Griffin Rd, Twentynine Palms, CA 92277 | 2018-11-06 |
| 1760615835 | Joseph A Miller | Dentist | 3406a Daly St, Twentynine Palms, CA 92277-9467 | 2009-08-24 |
| 1104963750 | An Van Nguyen | Dentist | 73666 Joshua Dr, Twentynine Palms, CA 92277-2572 | 2007-01-31 |
| 1316930738 | Taras Josaphat Konrad | Dentist | Mcagctc, 23rd Dental, Bldg 1591, Twentynine Palms, CA 92278 | 2005-08-31 |
| 1164081659 | Christopher Masaki Shimizu | Dentist | 1591 Griffin Road, Twentynine Palms, CA 92277 | 2019-06-10 |
| 1144797358 | George Chao | Dentist | 1591 Griffin Road, Twentynine Palms, CA 92278 | 2018-10-25 |
| 1386163616 | Adam Kenneth Gluskin | Dentist | 1591 Griffin Road, Twentynine Palms, CA 92277 | 2017-09-19 |
| 1215311832 | Paul Park | Dentist | 72724 29 Palms Hwy Ste 102, Twentynine Palms, CA 92277-2459 | 2015-07-14 |
| 1073927935 | Parisa Gheidarpour | Dentist | 72724 29 Palms Hwy, Suit 103, Twentynine Palms, CA 92277-2417 | 2014-06-18 |
| Find all providers in TWENTYNINE PALMS | ||||
| City | TWENTYNINE PALMS |
| Zip Code | 92278 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.