Jack D. Griffin, Jr., D.M.D., St. Charles, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014900 Issued in MO

Legal business name

JACK D. GRIFFIN, JR., D.M.D., ST. CHARLES, LLC

Practice address

1 Westbury Dr
Saint Charles, MO 63301-2550

Phone

(314) 488-1201

NPI assigned

Aug 30, 2016

Organization subpart

No

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

Authorized official

Name

Jack Griffin Jr., DMD

Title

Owner

Phone

(314) 488-1201

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1043766926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BARN SIDE LN",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WESTBURY DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012550",
            "telephone_number": "314-488-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK D. GRIFFIN, JR., D.M.D., ST. CHARLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-488-1201",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Irvine
• Sydney Irwin
• Johanna Elisabeth Iwaszkowiec, IBCLC
• Romel Izquierdo-Malon, M.D.
• Jody T Jachna, MD
• Keisha Jackson, LCSW
• Rachel Jackson, DPT
• Katherine Jaenke, MS, CCC-SLP
• Michelle Lynn Jagels, LPC
• Yousaf Jalil, M.D.

• General Practice Dentistry in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.