Active NPI
Kathryn Nicole Brennan
- Dentist
- Saint Louis, MO
National Provider Identifier
1093160814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2016023420
- Practice address
- 10733 Charrette Dr
Saint Louis, MO 63123-3914 - Phone
- (314) 691-2874
- NPI assigned
- Apr 29, 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 | 2016023420 | MO | Primary |
Addresses
Primary practice location
10733 Charrette Dr
Saint Louis, MO 63123-3914
Mailing address
10733 Charrette Dr
Saint Louis, MO 63123-3914
Phone (314) 691-2874
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 |
|---|---|---|---|
| 2016023420 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470528000000",
"number": "1093160814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10733 CHARRETTE DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631233914",
"telephone_number": "314-691-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10733 CHARRETTE DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631233914",
"telephone_number": "314-691-2874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "KATHRYN",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-29",
"last_updated": "2016-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2016023420",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.