NPIMap

Organization Active NPI

Barry D Brace, DMD & Associates, PC

  • General Practice Dentistry
  • Kirkwood, MO
National Provider Identifier
1013112234
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12409 Issued in MO
Legal business name
BARRY D BRACE, DMD & ASSOCIATES, PC
Practice address
469 S Kirkwood Rd
Kirkwood, MO 63122-6119
Phone
(314) 965-6503
Fax
(314) 965-7417
NPI assigned
Jun 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barry Brace, D.M.D
Title
Owner Dentist
Phone
(314) 965-6503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 12409 MO Primary

Addresses

Primary practice location

469 S Kirkwood Rd
Kirkwood, MO 63122-6119

Mailing address

469 S Kirkwood Rd
Kirkwood, MO 63122-6119
Phone (314) 965-6503

National Provider Directory

National Provider Directory

Locations

469 S Kirkwood Rd
Saint Louis, MO 63122
Phone (314) 965-6503

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013112234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226119",
            "telephone_number": "314-965-6503",
            "fax_number": "314-965-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226119",
            "telephone_number": "314-965-6503",
            "fax_number": "314-965-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY D BRACE, DMD & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRACE",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "314-965-6503",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.