Active NPI
Tonya Monique Long, DMD
- Dentist
- Park Hills, MO
National Provider Identifier
1033356803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2006021256
- Practice address
- 1025 W Main St
Park Hills, MO 63601-2079 - Phone
- (573) 431-1947
- NPI assigned
- Jan 15, 2009
- Last updated
- Jan 15, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2006021256 | MO | Primary |
Addresses
Primary practice location
1025 W Main St
Park Hills, MO 63601-2079
Mailing address
1008 Cedar Glade Rd
Bonne Terre, MO 63628-3630
Phone (314) 304-0897
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006021256 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Francois County Health Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Public Health or Welfare Agency
- Park Hills, MO
- NPI 1417921420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231977600000",
"number": "1033356803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 CEDAR GLADE RD",
"city": "BONNE TERRE",
"state": "MO",
"postal_code": "636283630",
"telephone_number": "314-304-0897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 W MAIN ST",
"city": "PARK HILLS",
"state": "MO",
"postal_code": "636012079",
"telephone_number": "573-431-1947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "TONYA",
"middle_name": "MONIQUE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-15",
"last_updated": "2009-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2006021256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Hills, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.