Provider Demographics
NPI:1194930289
Name:THOMAS & ROSKOS DMD PC
Entity type:Organization
Organization Name:THOMAS & ROSKOS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-838-3233
Mailing Address - Street 1:7350 S MCCLINTOCK DR
Mailing Address - Street 2:STE 104
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5006
Mailing Address - Country:US
Mailing Address - Phone:480-838-3233
Mailing Address - Fax:480-383-4775
Practice Address - Street 1:7350 S MCCLINTOCK DR
Practice Address - Street 2:STE 104
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5006
Practice Address - Country:US
Practice Address - Phone:480-838-3233
Practice Address - Fax:480-838-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841231867OtherNPI STEPHEN P THOMAS
AZ4816OtherSTATE LICENSE JMROSKOSJR
1942241047OtherNPI FOR PAUL Y THOMAS
1598704389OtherNPI JOHN M ROSKOS JR
AZ5631OtherSTATE LICENSE SPTHOMAS
AZ1818OtherSTATE LICENSE PYTHOMAS
BT5619652OtherDRUG LICENSE PYTHOMAS
BT7859412OtherDRUG LICENSE SPTHOMAS
AZ1818OtherSTATE LICENSE PYTHOMAS