KENNERLY DENTAL GROUP, INC. (NPI# 1811910250) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811910250 |
| Entity Type | Organization |
| Organization Name | KENNERLY DENTAL GROUP, INC. |
| Practice Address |
9906 Kennerly Rd Saint Louis MO 63128-2704 |
| Practice Telephone | 3148425177 |
| Practice Fax Number | 3148429935 |
| Mailing Telephone | 3148425177 |
| Mailing Fax Number | 3148429935 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. EDWIN RICHARD SCHERTZER JR. (PRESIDENT) |
| Authorized Official Telephone | 3148425177 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
012378 | MO | Dental Providers |
| Street Address |
9906 KENNERLY RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013061712 | Aaron Matthew Schertzer | Dentist | 9906 Kennerly Rd, Saint Louis, MO 63128-2704 | 2007-01-22 |
| 1518011212 | David Michael Schertzer | Dentist | 9906 Kennerly Rd, Saint Louis, MO 63128-2704 | 2007-01-22 |
| 1467506063 | Edwin Richard Schertzer Jr. | Dentist | 9906 Kennerly Rd, Saint Louis, MO 63128-2704 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| 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 |
|---|---|---|---|---|
| 1801493762 | Alexander Ahmadi | Dentist | 4171 Crescent Dr Ste 102, Saint Louis, MO 63129-3645 | 2020-10-05 |
| 1396353876 | Michael Rehme Jr. | Dentist | 2821 N Ballas Rd Ste 245, Saint Louis, MO 63131-2378 | 2020-07-21 |
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1013579010 | Jasmine Esmailzadegan | Dentist | 200 S Kirkwood Rd Ste 90, Saint Louis, MO 63122-4351 | 2019-07-01 |
| 1194295964 | Rivka Goldenhersh, D.m.d., LLC | Dentist | 620a N Mcknight Rd Ste 2a, Saint Louis, MO 63132 | 2018-12-04 |
| 1952895252 | Feras Al Khatib | Dentist | 7809 Watson Rd, Saint Louis, MO 63119-5408 | 2018-06-20 |
| 1255825675 | Brenton Patrick Ruopp | Dentist | 16 Hampton Village Plz Ste 229, Saint Louis, MO 63109-2111 | 2018-06-19 |
| 1598258501 | Daniel Thomas Doherty | Dentist | 621 S New Ballas Rd # 10, Saint Louis, MO 63141-8232 | 2018-06-13 |
| 1649700964 | Adam J Bree | Dentist | 605 Old Ballas Rd Ste 118, Saint Louis, MO 63141-7070 | 2017-06-19 |
| 1811448863 | We Care Mobile Dental LLC | Dentist | 6903 Waterman Ave, Saint Louis, MO 63130-4333 | 2016-10-14 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.