Michelle Parra Kleinheider

Key facts

NPI

1013000827

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

015972 (MO)

Practice address

1167 Colonnade Ctr
Des Peres, MO 63131-4328

Phone

(314) 822-0018

Fax

(314) 822-3802

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Opted out of Medicare

Yes, effective May 1, 2016 through May 1, 2028

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 25, 2016.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1013000827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 COLONNADE CTR",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631314328",
            "telephone_number": "314-822-0018",
            "fax_number": "314-822-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 COLONNADE CTR",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631314328",
            "telephone_number": "314-822-0018",
            "fax_number": "314-822-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEINHEIDER",
        "first_name": "MICHELLE",
        "middle_name": "PARRA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "015972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Des Peres, MO · General Practice Dentistry in Missouri