CRAIG CARL THIEDE D.D.S. NPI 1528127024

NPI Information

Craig Carl Thiede, D.D.S. is an oral and maxillofacial surgery dentist in Tustin, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Craig Carl Thiede, D.D.S. NPI is 1528127024. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

13522 NEWPORT AVE STE 109
TUSTIN, CA
ZIP 92780-707
Phone: (714) 730-6767
Fax: (714) 730-1161

The NPI 1528127024 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/8/2006 and was last updated on 3/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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