NPIMap

Organization Active NPI

Faye E Licata DMD Fagd PC

  • Dentist
  • Chesterfield, MO
National Provider Identifier
1033295464
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015059 Issued in MO
Legal business name
FAYE E LICATA DMD FAGD PC
Practice address
111 Hilltown Village Center
Suite #200
Chesterfield, MO 63017
Phone
(636) 532-2101
Fax
(636) 532-2209
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Authorized official

Name
Dr. Faye E Licata, DMDNPI 1881036630
Title
Dentist Owner
Phone
(636) 532-2101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 015059 MO Primary

Addresses

Primary practice location

111 Hilltown Village Center
Suite #200
Chesterfield, MO 63017

Mailing address

111 Hilltown Village Center
Suite #200
Chesterfield, MO 63017
Phone (636) 532-2101

National Provider Directory

National Provider Directory

Locations

111 Hilltown Village Ctr
Ste 200
Chesterfield, MO 63017
Phone (636) 532-2101

Practitioners & affiliated clinicians

Practitioners 1

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1033295464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HILLTOWN VILLAGE CENTER",
            "address_2": "SUITE #200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-532-2101",
            "fax_number": "636-532-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 HILLTOWN VILLAGE CENTER",
            "address_2": "SUITE #200",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "636-532-2101",
            "fax_number": "636-532-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYE E LICATA DMD FAGD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "LICATA",
        "authorized_official_first_name": "FAYE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "636-532-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "015059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 22, 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.

Verify at the official NPI Registry.