STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC (NPI# 1336314079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336314079 |
| Entity Type | Organization |
| Organization Name | STEPHEN W. HIATT DDS AND MARYANN L. UDY DMD PC |
| Other Organization Name | GEORGE T. SHUERT DDS AND STEPHEN W. HIATT DDS PC |
| Practice Address |
2992 Highway K Ste 133 O Fallon MO 63368-7861 |
| Mailing Address |
5551 Winghaven Blvd. Ste. 210 O'fallon MO 63368 |
| Practice Telephone | 6369786967 |
| Practice Fax Number | 6369785905 |
| Mailing Telephone | 6369786967 |
| Mailing Fax Number | 6369785905 |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2019-06-28 |
| Authorized Official Name | MRS. LANA S. WISNIEWSKI (BUSINESS MANAGER) |
| Authorized Official Telephone | 6369786967 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
011813 | MO | Dental Providers |
| Other Name | Type Code |
|---|---|
| George T. Shuert DDS and Stephen W. Hiatt DDS PC | Former Legal Business Name - Organization |
| Northwest Oral Surgeons | Doing Business As Name - Organization |
| Street Address |
2992 HIGHWAY K STE 133 |
| City | O FALLON |
| State | MO |
| Zip Code | 63368-7861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720329 | Come As You Are Counseling LLC | Counselor | 1001 Boardwalk Springs Place, Suite 111, O Fallon, MO 63368 | 2020-11-04 |
| 1770124802 | Lisa N. Greer | Technician | 6911 Brassel Dr., Ofallon, MO 63368 | 2019-09-30 |
| 1770145716 | Halie Faye Gulley | Dentist | 3009 Hwy K, O'fallon, MO 63368 | 2019-06-29 |
| 1972079556 | Erin Corsi Fraundorf | Dentist | 3009 State Hwy K, O'fallon, MO 63368 | 2018-10-22 |
| 1427579960 | Air Evac Ems, Inc. | Ambulance | 1001 Boardwalk Springs Pl Ste 250, O Fallon, MO 63368 | 2017-07-06 |
| 1528507472 | Washeck Manual Therapy LLC | Clinic/Center | 3074 Winghaven Blvd, O'fallon, MO 63368 | 2017-02-13 |
| 1639618457 | Brittany Hogan | Physical Therapist | 7412 South Outer 364, Suite B, Dardenne Prairie, MO 63368 | 2017-02-13 |
| 1124561469 | Cardinal Home Care LLC | Home Health | 18 Convent Garden Ct, O'fallon, MO 63368 | 2016-11-18 |
| 1336509272 | Sarah Marie Mudd | Counselor | 1654 Bryan Road, O'fallon, MO 63368 | 2016-03-04 |
| 1588023956 | Price-bourisaw Family Chiropractic | Chiropractor | 2917 State Highway K, O Fallon, MO 63368 | 2016-02-15 |
| Find all providers in zip 63368 | ||||
| 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 |
|---|---|---|---|---|
| 1942316617 | Stephen W. Hiatt | Dentist | 5551 Winghaven Blvd Ste 210, O Fallon, MO 63368 | 2006-08-22 |
| 1477613297 | Oral Surgeons of Southern Illinois | Dentist | 741 W State St, Suite 3, O Fallon, IL 62269-1971 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881202943 | Kansas City Oral Surgery & Implant Center | Dentist | 8771 N Platte Purchase Dr, Kansas City, MO 64155-1829 | 2020-07-15 |
| 1700403722 | Kansas City Facial and Oral Surgery, LLC | Dentist | 2931 Ne Independence Ave., Lees Summit, MO 64064-6406 | 2020-06-26 |
| 1134767866 | Courtney Ethington | Dentist | 4 West Dr Ste 170, Chesterfield, MO 63017-1793 | 2019-12-12 |
| 1184130528 | Archway Oral Surgery and Dental Implants | Dentist | 16 Hampton Village Plz Ste 200, Saint Louis, MO 63109-2128 | 2017-12-21 |
| 1780120410 | Ervin Simmons Iv Dmd LLC | Dentist | 3220 Parker Rd, Florissant, MO 63033-3733 | 2017-01-19 |
| 1437531209 | Federico Castillo Iv | Dentist | 2521 Cherry St, Kansas City, MO 64108-2750 | 2015-06-29 |
| 1437579208 | Gregory Lohr | Dentist | 2931 Ne Independence Ave, Lees Summit, MO 64064 | 2014-04-21 |
| 1114347861 | Zachary L Brown | Dentist | 4700 Belleview Ave Ste L10, Kansas City, MO 64112-1360 | 2014-04-21 |
| 1265868863 | Gregory Pernoud | Dentist | 1204 E State Route 72, Rolla, MO 65401-3938 | 2013-09-16 |
| 1942551247 | Kansas City Surgical Arts LLC | Dentist | 8080 North Flintlock Road, Kansas City, MO 64158 | 2012-09-26 |
| 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.