1. Home
  2. Directory
  3. Nevada
  4. Las Vegas
  5. Dentist
  6. NPI Profile

DR. ANGELICA JANE BUSTOS THACKER DMD
NPI 1073251963
Dentist - General Practice in Las Vegas, NV

Active since May 22, 2022PECOS Enrolled
7603 GRAND TETON DR STE 140, LAS VEGAS, NV 89131(702) 957-1013 Get Directions Write a Review

NPPES record last updated: March 17, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2023, May 22, 2022 (2 updates tracked since 2022).

About Dr. Angelica Jane Bustos Thacker Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANGELICA JANE BUSTOS THACKER DMD (NPI 1073251963) is an individual general practice provider in Las Vegas, Nevada, licensed in Nevada (7617) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073251963
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ANGELICA JANE BUSTOS THACKERCredential: DMD
Location Address7603 GRAND TETON DR STE 140Las Vegas, NV 89131-1602
Mailing Address12028 Hathaway Pines LnLas Vegas, NV 89138-4501 · (702) 883-9376
Phone(702) 957-1013
Sole ProprietorNo
Enumeration DateMay 22, 2022
Last NPPES UpdateMarch 17, 20232 updates tracked since enumeration
NPPES CertifiedMarch 17, 2023
✔ NPI 1073251963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NV · 7617
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
7603 GRAND TETON DR STE 140, Las Vegas, NV 89131
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Angelica Jane Bustos Thacker Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 89131 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.51 typical visit price
range $57.07 – $173.24
Typical copayment $22.12 (range $14.26 – $43.31)
Most-billed visit code 99203
Established Patient
$71.14 typical visit price
range $18.27 – $140.96
Typical copayment $17.78 (range $4.56 – $35.24)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SASCHA HUDSON DMD
Dentist (General Practice)
7603 GRAND TETON DR STE 140
LAS VEGAS, NV 89131
Clark County (702) 991-9999

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angelica Jane Bustos Thacker's NPI number?

The NPI number for Angelica Jane Bustos Thacker is 1073251963. It was assigned to this individual provider in the NPPES registry on May 22, 2022.

Where is Angelica Jane Bustos Thacker located?

Angelica Jane Bustos Thacker practices at 7603 Grand Teton Dr Ste 140, Las Vegas, NV 89131. The listed phone number is (702) 957-1013.

What is Angelica Jane Bustos Thacker's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Angelica Jane Bustos Thacker enrolled in Medicare?

Yes. Angelica Jane Bustos Thacker is registered in the Medicare PECOS enrollment system.

What insurance does Angelica Jane Bustos Thacker accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Angelica Jane Bustos Thacker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Angelica Jane Bustos Thacker was last updated on March 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.