NPIMap

Organization Active NPI

Missouri Dental Professionals, Richard Straus, DMD, PC

Doing business as Chesterfield Park Dental

  • General Practice Dentistry
  • Chesterfield, MO
National Provider Identifier
1013256452
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2003018551 Issued in MO
Legal business name
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC
Doing business as
Chesterfield Park Dental
Practice address
4 West Dr Ste 150
Chesterfield, MO 63017-1793
Phone
(636) 532-1661
Fax
(866) 262-1503
NPI assigned
Feb 5, 2013
Last updated
Apr 25, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Authorized official

Name
Kendra Walker
Title
Credentialing Team Lead
Phone
(217) 540-8513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2003018551 MO Primary

Addresses

Primary practice location

4 West Dr Ste 150
Chesterfield, MO 63017-1793

Mailing address

4 West Drive
Suite 150
Chesterfield, MO 63017
Phone (636) 532-1661

Other names 1

  • Chesterfield Park Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC60 organizations share this tax ID, including this one
Part of
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

4 West Dr
Ste 150
Chesterfield, MO 63017
Phone (636) 532-1661

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1013256452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WEST DRIVE",
            "address_2": "SUITE 150",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-532-1661",
            "fax_number": "866-262-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEST DR STE 150",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171793",
            "telephone_number": "636-532-1661",
            "fax_number": "866-262-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC",
        "enumeration_date": "2013-02-05",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8513"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2003018551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesterfield Park Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chesterfield Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.