Dr. Thomas Luke Bashaw, D.D.S.
Dentist in Elk River, MN. Individual provider (NPI-1).
NPI number1922065416
StatusActive
Last updated in NPPESAug 19, 2014
Details
- NPI
- 1922065416
- Entity type
- Individual (NPI-1)
- Name
- Dr. Thomas Luke Bashaw
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 27, 2006
- Last updated
- Aug 19, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D09824 | MN | Yes |
Practice location
710 Dodge Ave NwSuite B
Elk River, MN 55330-2019
Phone 763-441-3922
Mailing address
710 Dodge Ave NwSuite B
Elk River, MN 55330-2019
Phone 763-441-3922
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All 16 Dentist providers in Elk River · All 706 providers in Elk River
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