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ST. LOUIS PEDIATRIC DENTISTRY NPI 1629366760


NPI Information

NPI: 1629366760
Provider Name: ST. LOUIS PEDIATRIC DENTISTRY
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
4142 KEATON CROSSING BLVD
SUITE 102
O FALLON, MO
ZIP 63368
Phone: (636) 205-4639
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ST. LOUIS PEDIATRIC DENTISTRY is a pediatric dentistry dentist in O Fallon, MO. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. ST. LOUIS PEDIATRIC DENTISTRY NPI is 1629366760. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4142 KEATON CROSSING BLVD
SUITE 102
O FALLON, MO
ZIP 63368-404
Phone: (636) 205-4639
Fax: (314) 594-0742

The provider's authorized official is Lindsey Christian Reed .
The authorized official title is Pediatric Dentist/owner Of Practice and has the following contact phone number (636) 205-4639.

The enumeration date for this NPI number is 7/11/2011 and was last updated on 7/11/2011.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0221XDentistPediatric Dentistry2010006281MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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