St Clair Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ST CLAIR FAMILY DENTISTRY

Practice address

525 E Springfield Rd
Saint Clair, MO 63077-1735

Phone

(636) 629-1103

NPI assigned

Mar 22, 2019

Last updated

Mar 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Buckley, DDSNPI 1679981153

Title

Ceo

Phone

(314) 566-9072

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Phillip Buckley, DDS

  • Dentist
  • Saint Clair, MO
  • NPI 1679981153
  NPD (past) Authorized official
• James Leroy Bunge, DDS

  • General Practice Dentistry
  • Saint Clair, MO
  • NPI 1184845729
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1073073227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 TAMARISK DR",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485594",
            "telephone_number": "314-566-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E SPRINGFIELD RD",
            "city": "SAINT CLAIR",
            "state": "MO",
            "postal_code": "630771735",
            "telephone_number": "636-629-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-566-9072",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick J Rose, M.D.
• Natalie Schroeder, M.A. CCC-SLP
• Amanda Slater, COTA/L
• Patrick Raymond Smith, M.D.
• St Clair Allergy-Asthma
• St Clair Nursing LLC (St Clair Nursing Center)
• St Clair Physical Therapy Inc
• St Clair Rexall Drug Store (St. Clair Health Mart Pharmacy)
• St. Clair Ambulance District
• St. Clair Reorganized District R-Xiii

• Dental Clinic/Center in Saint Clair, MO
• Providers in Saint Clair, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.