COURTNEY ETHINGTON (NPI# 1134767866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134767866 |
Entity Type | Individual |
Full Name | COURTNEY ETHINGTON |
Credential | DMD, MSD |
Practice Address |
4 West Dr Ste 170 Chesterfield MO 63017-1793 |
Mailing Address |
1109 E Linden Ave Saint Louis MO 63117-1378 |
Practice Telephone | 6367789345 |
Enumeration Date | 2019-12-12 |
Last Update Date | 2019-12-12 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2019043361 | MO | Dental Providers |
N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
019.032433 | IL | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | MISSOURI DENTAL LICENSE | 2019043361 | 01 |
IL | ILLINOIS DENTAL LICENSE | 019.032433 | 01 |
Street Address |
4 WEST DR STE 170 |
City | CHESTERFIELD |
State | MO |
Zip Code | 63017-1793 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
Find all providers in zip 63017 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790923365 | Reza Movahed | Dentist | 1585 Woodlake Dr Ste 208, Chesterfield, MO 63017-5740 | 2009-02-04 |
1356405740 | Chesterfield Oral Surgery Inc. | Dentist | 10110 Iron Bridge Rd, Chesterfield, VA 23832-6529 | 2006-12-20 |
1922195395 | Timothy M Weber | Dentist | 222 S Woodsmill Road, Suite 720 North, Chesterfield, MO 63017 | 2006-10-06 |
1831155076 | Brent L Kincaid | Dentist | 222 S Woods Mill Rd Ste 720n, Chesterfield, MO 63017-3650 | 2006-04-25 |
1225015068 | Scott A. Drooger | Dentist | 17300 Outer Forty Road North, Suite 103, Chesterfield, MO 63005 | 2005-12-22 |
1114498946 | Clarkson Oral Surgery | Dentist | 2997 Clarkson Rd, Ste 120, Chesterfield, MO 63017 | 2018-12-05 |
1447516794 | Bradley Ross Carn | Dentist | 222 S Woods Mill Rd Ste 720n, Chesterfield, MO 63017 | 2012-04-11 |
1053549816 | David E. Urbanek | Dentist | 17300 Outer Forty Road North, Suite 103, Chesterfield, MO 63005 | 2009-06-30 |
1871764233 | Susan Ann Godwin | Dentist | 16216 Baxter Rd, Suite 250, Chesterfield, MO 63017-4770 | 2008-03-13 |
1073709226 | Weber Dds PC | Dentist | 222 S Woods Mill Rd, Suite 720n, Chesterfield, MO 63017-3625 | 2007-09-21 |
Find all providers in CHESTERFIELD |
City | CHESTERFIELD |
Zip Code | 63017 |
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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.