Individual provider Active NPI

Aurelia A Dunagan, D.M.D.

  • Pediatric Dentistry
  • Chesterfield, MO
National Provider Identifier
1073610622
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
014924 Issued in MO
Practice address
14377 Woodlake Dr
Suite 102
Chesterfield, MO 63017-5735
Phone
(314) 576-4335
Fax
(314) 576-4408
NPI assigned
Sep 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 014924 MO Primary

Addresses

Primary practice location

14377 Woodlake Dr
Suite 102
Chesterfield, MO 63017-5735

Mailing address

14377 Woodlake Dr
Suite 102
Chesterfield, MO 63017-5735
Phone (314) 576-4335

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

LicenseStateTypeSpecialty
014924MOMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073610622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 102",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-576-4335",
            "fax_number": "314-576-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "SUITE 102",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-576-4335",
            "fax_number": "314-576-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNAGAN",
        "first_name": "AURELIA",
        "middle_name": "A",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "014924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.