Active NPI
Carissa Bruening, D.D.S.
- Dentist
- Chesterfield, MO
National Provider Identifier
1063860930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2016016881
- Practice address
- 130 Hilltown Village Ctr
Chesterfield, MO 63017-0709 - Phone
- (636) 532-3311
- NPI assigned
- Jun 1, 2016
- 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 | 2016016881 | MO | Primary |
Addresses
Primary practice location
130 Hilltown Village Ctr
Chesterfield, MO 63017-0709
Mailing address
1387 Norwood Hills Dr
O Fallon, MO 63366-5561
Phone (316) 680-9116
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 |
|---|---|---|---|
| 2016016881 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1063860930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1387 NORWOOD HILLS DR",
"city": "O FALLON",
"state": "MO",
"postal_code": "633665561",
"telephone_number": "316-680-9116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 HILLTOWN VILLAGE CTR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630170709",
"telephone_number": "636-532-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUENING",
"first_name": "CARISSA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-01",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2016016881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MO
- Steven M Brown, M.D.
- Suzanne Michele Bruce, PT
- Michelle Jacqueline Brueggemann, MPT
- Bruening Dental LLC (Chesterfield Woodlake Dental)
- Andrew Roger Bruening, D.D.S.
- Kimberly A Brune Shrum, NP-C
- Neal Brunkhorst, CRNA
- Tina Brunsmann, OTR
- Debra Kay Bryant, BCBA
- BTL Ventures LLC (Home Helpers Home Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.