Active NPI
H John Scanlon, DDS
- General Practice Dentistry
- Florissant, MO
National Provider Identifier
1003936642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12743
- Practice address
- 4585 Washington St
Suite A3
Florissant, MO 63033-5858 - Phone
- (314) 921-4333
- Fax
- (314) 921-8632
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12743 | MO | Primary |
Addresses
Primary practice location
4585 Washington St
Suite A3
Florissant, MO 63033-5858
Mailing address
3004 S Saint Peters Pkwy
Suite I
Saint Peters, MO 63303-6354
Phone (636) 441-1020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12743 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harold John Scanlon DDS PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Saint Peters, MO
- NPI 1679545404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378944000000",
"number": "1003936642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3004 S SAINT PETERS PKWY",
"address_2": "SUITE I",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633036354",
"telephone_number": "636-441-1020",
"fax_number": "636-441-4360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4585 WASHINGTON ST",
"address_2": "SUITE A3",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630335858",
"telephone_number": "314-921-4333",
"fax_number": "314-921-8632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCANLON",
"first_name": "H",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2013-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "12743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.