Provider Demographics
NPI:1194317560
Name:THOMAS, BRINI (DMD)
Entity type:Individual
Prefix:
First Name:BRINI
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 DEL MAR DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060-4882
Mailing Address - Country:US
Mailing Address - Phone:972-268-0160
Mailing Address - Fax:
Practice Address - Street 1:100 HUDSON OAKS DR STE 110
Practice Address - Street 2:
Practice Address - City:HUDSON OAKS
Practice Address - State:TX
Practice Address - Zip Code:76087-4709
Practice Address - Country:US
Practice Address - Phone:817-717-9653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX400961223G0001X
IL019.0329611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty