COLIN CICCHETTI (NPI# 1760863807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760863807 |
| Entity Type | Individual |
| Full Name | COLIN CICCHETTI |
| Practice Address |
1 Southtowne Dr Potosi MO 63664-5729 |
| Practice Telephone | 5734388358 |
| Mailing Telephone | 5734388358 |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2015018308 | MO | Dental Providers |
| Street Address |
1 SOUTHTOWNE DR |
| City | POTOSI |
| State | MO |
| Zip Code | 63664-5729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386631596 | Marianne Klemm | Family Medicine | 1 Southtowne Dr, Suite B, Potosi, MO 63664-5729 | 2005-10-03 |
| 1144831124 | Kristin R Jennings | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-08-12 |
| 1124648423 | Penny Kaye Grechus | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2020-04-16 |
| 1447893003 | Emily Morgan Kelley | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-10-25 |
| 1093367591 | Jill Bleything | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-15 |
| 1336701606 | Kyungsang Lee | Dentist | 1 Southtowne Dr, Potosi, MO 63664 | 2019-07-08 |
| 1992367213 | Shannon Michelle Leftridge | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-07-08 |
| 1033683354 | Gregory A Roeback | Counselor | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2019-01-21 |
| 1205318490 | Terra Renee Graves | Social Worker | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2018-09-04 |
| 1578092797 | Brittany Nicole Helms | Nurse Practitioner | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2017-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083017461 | Carolyn Coyne Maryan | Specialist/Technologist | 400 Mine St., Citadel School, Potosi, MO 63664 | 2014-09-30 |
| 1205073665 | Potosi Chiropractic Life Center | Chiropractor | 502 North Missouri St., Potosi, MO 63664 | 2009-01-07 |
| 1932385952 | Simpelo Medical Clinic, P.C. | Internal Medicine | 108 Frizzell, Suite 6, Potosi, MO 63664 | 2008-01-22 |
| 1760696918 | Brett T Snodgrass | General Practice | 1 Southtowne Dr., Great Mines Health Center, Potosi, MO 63664 | 2007-05-09 |
| 1710032297 | Washington County Handicapped Services Adult Day Health Care | Day Training, Developmentally Disabled Services | 10604 West Highway E, Potosi, MO 63664 | 2007-01-24 |
| 1578629473 | Greenlee Chiropractic Inc. | Chiropractor | Greenlee Chiropractic, 417 East High St, Potosi, MO 63664 | 2006-12-28 |
| 1003981895 | James Daley Robart Jr. | Chiropractor | 912 N Missouri St, Potosi, MO 63664 | 2006-11-21 |
| 1225063407 | Seth Paskon | Internal Medicine | Potosi Medical Clinic, #1 Kwan Plaza, Potosi, MO 63664 | 2006-07-12 |
| 1346295607 | Donna Yates | Nurse Practitioner | 600 Purcell Dr, Suite B, Potosi, MO 63664 | 2006-05-24 |
| 1467424788 | Washington County Memorial Hospital | Clinic/Center | 108 Frizzell Street, Potosi, MO 63664 | 2006-02-02 |
| Find all providers in zip 63664 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235111998 | Paul Francis Villmer | Dentist | 10523 W State Hwy E, Potosi, MO 63664-2030 | 2005-11-17 |
| 1801182704 | Benjamin Earl Dewaal | Dentist | 1 Southtowne Dr, Potosi, MO 63664-5729 | 2011-06-20 |
| 1225199342 | Stephen Mckown Matthews | Dentist | 200 Health Way Dr, Suite 1, Potosi, MO 63664-1434 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322990 | Wildhorse Dental Care, LLC | Dentist | 399 Patriotic Trl, Weldon Spring, MO 63304-7936 | 2020-10-05 |
| 1801493762 | Alexander Ahmadi | Dentist | 4171 Crescent Dr Ste 102, Saint Louis, MO 63129-3645 | 2020-10-05 |
| 1184239832 | Adam Wesley Gadbois | Dentist | 220 Diego Dr, Columbia, MO 65203-4919 | 2020-09-10 |
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1538778592 | Maya Grace Habibi | Dentist | 5212 N Service Rd, Saint Peters, MO 63376-3950 | 2020-07-27 |
| 1427667500 | Breakthrough Dental Partners LLC | Dentist | 401 E Mechanic St, Harrisonville, MO 64701-2427 | 2020-07-24 |
| 1396353876 | Michael Rehme Jr. | Dentist | 2821 N Ballas Rd Ste 245, Saint Louis, MO 63131-2378 | 2020-07-21 |
| 1790303774 | Wed Khizirpour | Dentist | 1680 Nw Chipman Rd, Lees Summit, MO 64081-3934 | 2020-07-07 |
| 1275150716 | Hills Dentistry LLC | Dentist | 2000 Kentucky Ave Ste C, Platte City, MO 64079-7714 | 2020-07-01 |
| 1134745227 | Kayla White | Dentist | 1401 Forum Blvd Ste 203, Columbia, MO 65203-1915 | 2020-06-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COLIN CICCHETTI.
| 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.