CREVE COEUR ORAL SURGERY (NPI# 1891107132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891107132 |
| Entity Type | Organization |
| Organization Name | CREVE COEUR ORAL SURGERY |
| Practice Address |
605 Old Ballas Rd Suite 130 Saint Louis MO 63141-7000 |
| Mailing Address |
22 N Euclid Ave Suite 220 Saint Louis MO 63108-1407 |
| Practice Telephone | 3143610760 |
| Practice Fax Number | 3143677726 |
| Mailing Telephone | 3143610760 |
| Mailing Fax Number | 3143677726 |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |
| Authorized Official Name | AMANDA ANDREWS (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 3143610760 |
| Is Organization Subpart | Y |
| Parent Organization Name | JAY F HAUSER DDS PC DBA PREMIER DENTAL PARTNERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
605 OLD BALLAS RD SUITE 130 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689787459 | Phillip Brick | Internal Medicine | 605 Old Ballas Rd, Suite 200, Saint Louis, MO 63141-7000 | 2006-08-16 |
| 1699124065 | Shayla Marie Barber | Dentist | 605 Old Ballas Rd, Suite 118, Saint Louis, MO 63141-7000 | 2016-06-07 |
| 1790198711 | Brandon Robert Doerr | Dentist | 605 Old Ballas Rd, Suite 118, Saint Louis, MO 63141-7000 | 2014-06-06 |
| 1942640750 | Dani Rae Gray | Dentist | 605 Old Ballas Rd, Saint Louis, MO 63141-7000 | 2013-06-26 |
| 1427396126 | Cynthia Mae Hovis | Social Worker | 605 Old Ballas Rd, Suite 123, Saint Louis, MO 63141-7000 | 2013-01-30 |
| 1568788925 | Collin Miles Stutz | Dentist | 605 Old Ballas Rd, Saint Louis, MO 63141-7000 | 2010-04-10 |
| 1720285554 | Emily Jean Adams | Audiologist | 605 Old Ballas Rd, Saint Louis, MO 63141-7000 | 2007-06-27 |
| 1851592356 | Matthew Kane Birke | Dentist | 605 Old Ballas Rd, Suite 118, Saint Louis, MO 63141-7000 | 2007-05-30 |
| 1306972195 | Bi-state Medical Consultants, Inc. | Internal Medicine | 605 Old Ballas Rd, Suite 200, Saint Louis, MO 63141-7000 | 2007-02-26 |
| 1093860686 | Ashley M Loiterstein | Counselor | 605 Old Ballas Rd, Suite 123, Saint Louis, MO 63141-7000 | 2007-01-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 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 |
| 1114190220 | Allen Sclaroff Dds Inc | Dentist | 1 Barnes Jewish Hospital Plz, Suite 16432, Saint Louis, MO 63110-1003 | 2008-04-09 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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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.