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CARROLLWOOD DENTAL GROUP LLC NPI 1821216060


NPI Information

NPI: 1821216060
Provider Name: CARROLLWOOD DENTAL GROUP LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
12147 NATURAL BRIDGE RD
BRIDGETON, MO
ZIP 63044
Phone: (314) 739-3700
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CARROLLWOOD DENTAL GROUP LLC is a general practice dentist in Bridgeton, MO. The provider is 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. CARROLLWOOD DENTAL GROUP LLC NPI is 1821216060. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

12147 NATURAL BRIDGE RD
BRIDGETON, MO
ZIP 63044-018
Phone: (314) 739-3700
Fax: (314) 739-5048

The provider's authorized official is Victor L Clark .
The authorized official title is Owner and has the following contact phone number (314) 739-3700.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.


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
11223G0001XDentistGeneral Practice14202MISSOURINo
21223G0001XDentistGeneral Practice013326MISSOURINo
31223G0001XDentistGeneral Practice2003012113MISSOURIYes

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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