DR. DOMINIC MOREL-MAYNARD


Address: 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239
Phone: 3142516725

DR. DOMINIC MOREL-MAYNARD (NPI# 1073800520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1073800520
Entity Type Individual
Full Name DR. DOMINIC MOREL-MAYNARD
Credential D.M.D.
Practice Address 621 S New Ballas Rd Ste 16a
Saint Louis
MO 63141-8239
Practice Telephone 3142516725
Practice Fax Number 3142516726
Mailing Telephone 3142516725
Mailing Fax Number 3142516726
Enumeration Date 2011-07-06
Last Update Date 2019-01-18
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
2018010876 MO Dental Providers
N 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
DN 21761 FL Dental Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
111 E 210th St, Bronx, NY 104672401 7189205993
7401 N University Dr Ste 102, Tamarac, FL 333212933 9547217990

Office Location

Street Address 621 S NEW BALLAS RD STE 16A
City SAINT LOUIS
State MO
Zip Code 63141-8239

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346382678 Ramani Gowducheruvu Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2007-02-13
1770962953 Kiara Danielle Brown Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2015-05-21
1396180436 Dustin R Altmann Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2013-05-02
1164866125 Gregory Stephen Tentindo Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2013-04-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679102842 Noor Ramadan Pharmacist 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 2020-04-08
1497381206 Washington University Durable Medical Equipment & Medical Supplies 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 2020-03-13
1154956498 Ashleigh Clendenny Physician Assistant Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 2020-03-06
1801429410 Emili Lou Haley Registered Nurse 650 Maryville Drive, St Louis, MO 63141 2020-02-21
1629553110 Rebecca Kathleen Pike Social Worker West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 2018-10-01
1649756099 River City Sedation Associates, LLC Nurse Anesthetist, Certified Registered 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 2018-07-18
1205333952 Ear Care and Hearing of St. Louis Hearing Aid Equipment 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 2018-04-10
1659897486 Erin Goodman Physical Therapist 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 2017-08-14
1093230450 Center for Urologic Surgery LLC Clinic/Center 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 2017-08-07
1871016105 Jacob Farley Tanner Specialist/Technologist 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 2017-07-19
Find all providers in zip 63141

Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184130528 Archway Oral Surgery and Dental Implants Dentist 16 Hampton Village Plz Ste 200, Saint Louis, MO 63109-2128 2017-12-21
1346382678 Ramani Gowducheruvu Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2007-02-13
1528503026 Stewart E Moreland, Dmd, LLC Dentist 2821 N Ballas Rd, Suite 225, Saint Louis, MO 63131-2321 2016-12-20
1891107132 Creve Coeur Oral Surgery Dentist 605 Old Ballas Rd, Suite 130, Saint Louis, MO 63141-7000 2014-05-21
1396180436 Dustin R Altmann Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2013-05-02
1164866125 Gregory Stephen Tentindo Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2013-04-22
1568788925 Collin Miles Stutz Dentist 605 Old Ballas Rd, Saint Louis, MO 63141-7000 2010-04-10
1821228628 Robert Alexander Peter Reti Dentist 10000 Watson Rd, A, Saint Louis, MO 63126-1841 2009-07-15
1982870663 Marc Gayed Dentist 4121 Elm Park Dr, Saint Louis, MO 63128 2008-05-02
1114190220 Allen Sclaroff Dds Inc Dentist 1 Barnes Jewish Hospital Plz, Suite 16432, Saint Louis, MO 63110-1003 2008-04-09
Find all providers in SAINT LOUIS

Competitor

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City SAINT LOUIS
Zip Code 63141

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Dataset Information

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.

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