MR. EUGENIO G HERBOSA (NPI# 1063593838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063593838 |
| Entity Type | Individual |
| Full Name | MR. EUGENIO G HERBOSA |
| Credential | DMD MMSC |
| Practice Address |
12818 Tesson Ferry Road Suite 204 St Louis MO 63128 |
| Mailing Address |
1034 S Brentwood Suite 1010 St Louis MO 63128 |
| Practice Telephone | 3148420020 |
| Practice Fax Number | 3148421590 |
| Mailing Telephone | 3147211010 |
| Mailing Fax Number | 3147215276 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | 15229 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
12818 TESSON FERRY ROAD SUITE 204 |
| City | ST LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225147853 | John R Monterubio | Oral & Maxillofacial Surgery | 1034 S Brentwood, Suite 1010, St Louis, MO 63117 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609162189 | Rebecca Lindsay Grammer | Oral & Maxillofacial Surgery | 1034 S. Brentwood, Suite 1010, St. Louis, MO 63117-1210 | 2011-06-23 |
| 1659538973 | Michael J Pernoud Dds PC | Oral & Maxillofacial Surgery | 1015 Washington Sq Ste F, Washington, MO 63090-5307 | 2008-05-22 |
| 1912173592 | John O'connor Heiman | Oral & Maxillofacial Surgery | 4545 Wornall Rd, # 608, Kansas City, MO 64111-3270 | 2008-05-05 |
| 1730222647 | Matthew W Sheffer | Oral & Maxillofacial Surgery | 5227 S Main St Ste B, Joplin, MO 64804-4938 | 2007-02-14 |
| 1558415075 | Roberet L Ward | Oral & Maxillofacial Surgery | 1325 N Mt Auburn Rd, Cape Giraedeau, MO 63701 | 2007-01-22 |
| 1790849834 | Edward Steven Czebrinski | Oral & Maxillofacial Surgery | 77 Westport Plaza Medical Center, Suite 356, Saint Louis, MO 63146 | 2006-12-21 |
| 1912019290 | David M Ivey Dds PC | Oral & Maxillofacial Surgery | One Mid Rivers Mall Dr, Ste 310, St Peters, MO 63376-4323 | 2006-08-31 |
| 1285017806 | Marion Harris | Oral & Maxillofacial Surgery | 2301 Holmes St, Kansas City, MO 64108-2640 | 2015-06-30 |
| 1851618847 | Aosdi, Glenn J Makowski, Dmd, Md, PC | Oral & Maxillofacial Surgery | 2602 Cunningham Ave, Joplin, MO 64804-1542 | 2010-04-29 |
| 1699901868 | Thaer Daifallah | Oral & Maxillofacial Surgery | 2301 Holmes St, Kansas City, MO 64108-2640 | 2009-06-02 |
| Find all providers with the same taxonomy | ||||
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| 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.