NPIMap

Organization Active NPI

David Guilbeault DMD Florissant Dental Group LLC

Doing business as Florissant Dental Group

  • General Practice Dentistry
  • Florissant, MO
National Provider Identifier
1063804789
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2000174030 Issued in MO
Legal business name
DAVID GUILBEAULT DMD FLORISSANT DENTAL GROUP LLC
Doing business as
Florissant Dental Group
Practice address
1645 N New Florissant Rd
Florissant, MO 63033-2125
Phone
(314) 838-3033
NPI assigned
Mar 4, 2015
Last updated
Mar 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Authorized official

Name
David Guilbeault, DDS
Title
Dentist/Owner
Phone
(618) 248-2038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2000174030 MO Primary

Addresses

Primary practice location

1645 N New Florissant Rd
Florissant, MO 63033-2125

Mailing address

1922 Edwardsville Club Plaza CT
Edwardsville, IL 62025-3717

Other names 1

  • Florissant Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425427200000",
    "number": "1063804789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 EDWARDSVILLE CLUB PLAZA CT",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 N NEW FLORISSANT RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332125",
            "telephone_number": "314-838-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID GUILBEAULT DMD FLORISSANT DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A",
        "authorized_official_last_name": "GUILBEAULT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "618-248-2038",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2000174030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florissant Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.