Active NPI
Richard Emer McDermott, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- O Fallon, MO
National Provider Identifier
1013191618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2005031267
- Practice address
- 3006 Highway K
O Fallon, MO 63368-8675 - Phone
- (636) 978-8848
- Fax
- (636) 978-0240
- NPI assigned
- Dec 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2005031267 | MO | Primary |
Addresses
Primary practice location
3006 Highway K
O Fallon, MO 63368-8675
Mailing address
506 Forest Grove Dr
Fenton, MO 63026-3052
Phone (636) 343-3633
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005031267 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198022400000",
"number": "1013191618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 FOREST GROVE DR",
"city": "FENTON",
"state": "MO",
"postal_code": "630263052",
"telephone_number": "636-343-3633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3006 HIGHWAY K",
"city": "O FALLON",
"state": "MO",
"postal_code": "633688675",
"telephone_number": "636-978-8848",
"fax_number": "636-978-0240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "RICHARD",
"middle_name": "EMER",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-12-19",
"last_updated": "2007-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "2005031267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in O Fallon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.