Provider Demographics
NPI:1174154397
Name:MCALPIN, THADDEUS JORDAN (DDS)
Entity type:Individual
Prefix:DR
First Name:THADDEUS
Middle Name:JORDAN
Last Name:MCALPIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20061 E RITTENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-9715
Mailing Address - Country:US
Mailing Address - Phone:480-918-6101
Mailing Address - Fax:
Practice Address - Street 1:20061 E RITTENHOUSE RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-9715
Practice Address - Country:US
Practice Address - Phone:858-705-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002040731223G0001X
AZ0123521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice