16111 MANCHESTER ROAD, L.L.C. (NPI# 1013386598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013386598 |
| Entity Type | Organization |
| Organization Name | 16111 MANCHESTER ROAD, L.L.C. |
| Other Organization Name | ZIEBA FAMILY DENTISTRY |
| Practice Address |
428 Old State Rd. Ellisville MO 63021 |
| Practice Telephone | 6363916030 |
| Practice Fax Number | 6365278386 |
| Mailing Telephone | 6363916030 |
| Mailing Fax Number | 6365278386 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |
| Authorized Official Name | MR. CHARLES M. ZIEBA (DENTIST/OWNER) |
| Authorized Official Telephone | 6363916030 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
2000165488 | MO | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2000169958 | MO | Dental Providers |
| Other Name | Type Code |
|---|---|
| Zieba Family Dentistry | Doing Business As Name - Organization |
| Street Address |
428 OLD STATE RD. |
| City | ELLISVILLE |
| State | MO |
| Zip Code | 63021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972121176 | Elise Marie Webster | Dietitian, Registered | 822 Posthorn Dr., Manchester, MO 63021 | 2020-07-14 |
| 1386164713 | Our Care LLC | Internal Medicine | 1742 Carman Ridge Ct, Ballwin, MO 63021 | 2017-06-27 |
| 1134675788 | Summit Home Healthcarre, LLC | Home Health | 11511 Manchester Road, Ellisville, MO 63021 | 2016-09-01 |
| 1730530114 | Windalee Cowell-mccavron | Speech-Language Pathologist | 332 Old State Rd, Ellisville, MO 63021 | 2016-06-27 |
| 1609285816 | Daniel Rackovan | Specialist/Technologist | 13537 Barret Pkwy Dr, 105, Ballwin, MO 63021 | 2014-08-13 |
| 1952651341 | Faisal Alasmari | General Acute Care Hospital | 13928 Reflection Drive, Reflection Cove Apartments, Apt#235, Ballwin, MO 63021 | 2012-09-13 |
| 1831444694 | Manuel A. Ventus | General Practice | 651 Kerryton Pl. Circle, Balwin, MD 63021 | 2012-07-18 |
| 1073879052 | Delois Ann Hurst | Podiatrist | 1393 Big Bend Rd, Ballwin, MO 63021 | 2012-04-04 |
| 1841566445 | Elizabeth Riedel | Home Health | 13610 Barrett Office Drive, Manchester, MO 63021 | 2012-03-28 |
| 1225300403 | Robert Vernon Snyders Sr. | Family Medicine | 1638 Wolf Trail Rd., Ballwin, MO 63021 | 2012-02-02 |
| Find all providers in zip 63021 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972851814 | Dental Group of Ellisville, Pllc | Dentist | 97 Hal Crocker Road, Ellisville, MS 39437 | 2012-08-27 |
| 1114289394 | Alecia A Moore | Dentist | 97 Hal Crocker Rd, Ellisville, MS 39437-2088 | 2012-06-13 |
| 1578694709 | Bernard David Wilken | Dentist | 265 Clarkson Rd, Ellisville, MO 63011-2219 | 2007-03-08 |
| 1346399953 | Stephen L Surber | Dentist | 401 Highway 11 S, Ellisville, MS 39437-3103 | 2007-01-10 |
| 1760549380 | Michael P Frith Dds | Dentist | 269 Clarkson Rd, Ellisville, MO 63011-2219 | 2007-01-02 |
| 1518028703 | Andrew G. Mitchell, Inc. | Dentist | 15991 Manchester Rd, Ellisville, MO 63011-2140 | 2006-12-12 |
| 1639244700 | Frederick Alan Karwas | Dentist | 184 Clarkson Rd, Ellisville, MO 63011-2244 | 2006-11-22 |
| 1184720252 | Gilbert R. Hart | Dentist | 428 Old State Rd, Ellisville, MO 63021-5918 | 2006-09-16 |
| 1396758793 | Crystal Martin | Dentist | 277 Clarkson Rd, Ste 100, Ellisville, MO 63011 | 2006-08-15 |
| 1992235899 | Megan Michelle Wolf | Dentist | 12 Hutchinson Rd, Ellisville, MO 63011-5702 | 2017-06-14 |
| Find all providers in ELLISVILLE | ||||
| City | ELLISVILLE |
| Zip Code | 63021 |
Please comment or provide details below to improve the information on 16111 MANCHESTER ROAD, L.L.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.