GREATER ST LOUIS ORAL & MAXILLOFACIAL SURGERY PC


Address: 1034 S Brentwood Blvd, Suite 1010, Saint Louis, MO 63117-1223
Phone: 3147211010

GREATER ST LOUIS ORAL & MAXILLOFACIAL SURGERY PC (NPI# 1518158989) 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) 1518158989
Entity Type Organization
Organization Name GREATER ST LOUIS ORAL & MAXILLOFACIAL SURGERY PC
Other Organization Name MONTERUBIO AND HERBOSA ORAL AND MAXILLOFACIAL SURGERY
Practice Address 1034 S Brentwood Blvd
Suite 1010
Saint Louis
MO 63117-1223
Practice Telephone 3147211010
Practice Fax Number 3147215276
Mailing Telephone 3147211010
Mailing Fax Number 3147215276
Enumeration Date 2007-08-09
Last Update Date 2020-02-12
Authorized Official Name DR. JOHN R MONTERUBIO (PRESIDENT)
Authorized Official Telephone 3147211010
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
Dental Providers

Other Provider/Organization Names

Other Name Type Code
Monterubio and Herbosa Oral and Maxillofacial Surgery Former Legal Business Name - Organization

Office Location

Street Address 1034 S BRENTWOOD BLVD
SUITE 1010
City SAINT LOUIS
State MO
Zip Code 63117-1223

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720082233 Levi S Kirkland Jr. Surgery 1034 S Brentwood Blvd, Suite 694, Saint Louis, MO 63117-1223 2005-06-13
1770028953 Christina Cammon Nurse Practitioner 1034 S Brentwood Blvd, Suite 516, Saint Louis, MO 63117-1223 2016-12-27
1396289468 Natalie Beth Antin Social Worker 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 2016-12-08
1417490772 Patrick Alan Behnke Nurse Practitioner 1034 S Brentwood Blvd, Suite 600, Saint Louis, MO 63117-1223 2016-11-18
1457803611 St Louis Trauma Counseling LLC Social Worker 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 2016-11-03
1912459439 360 Health Care, LLC In Home Supportive Care 1034 S Brentwood Blvd, Suite 450a, Saint Louis, MO 63117-1223 2016-11-01
1083162416 John Petrovich Specialist 1034 S Brentwood Blvd, Suite 450a, Saint Louis, MO 63117-1223 2016-09-14
1609320076 Allyson Graves Speech-Language Pathologist 1034 S Brentwood Blvd, #300, Saint Louis, MO 63117-1223 2016-08-15
1609237718 Christine Shore-fitzgerald Social Worker 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 2016-03-16
1164883518 St. Louis Dbt, LLC Social Worker 1034 S Brentwood Blvd, Suite 555, Saint Louis, MO 63117-1223 2016-03-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1255956611 Efehi Kelly Ogbomo Student in an Organized Health Care Education/Training Program 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 2020-06-11
1619533890 Abdul Rauf Student in an Organized Health Care Education/Training Program 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 2019-05-14
1083278477 Mohamed Maali Gumaa Mohamed Student in an Organized Health Care Education/Training Program 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 2019-05-01
1750945556 Samrat Jun Jayanth Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 2019-04-26
1215491329 Latonya Allen Counselor 1612 S. Big Bend Blvd, St. Louis, MO 63117 2019-01-23
1265917025 Blue Stars Therapy, LLC Occupational Therapist 1101 Edward Terrace, Apt A, St. Louis, MO 63117 2018-09-27
1770060014 Ultra Care Home Services LLC Home Health 7353 Dale Ave, Saint Louis, MO 63117 2018-07-19
1235623562 Melissa Valerie Taylor Counselor Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 2018-06-20
1124517289 Jideofor Ebony Obodozie Student in an Organized Health Care Education/Training Program 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 2018-05-04
1770071706 Sivaram Prabhuji Muppaneni Student in an Organized Health Care Education/Training Program Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 2018-04-25
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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
1073800520 Dominic Morel-maynard Dentist 621 S New Ballas Rd Ste 16a, Saint Louis, MO 63141-8239 2011-07-06
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
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Competitor

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City SAINT LOUIS
Zip Code 63117

Improve Information

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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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