Individual provider Active NPI

Eric Matthew Foss, D.D.S., M.S.

  • Endodontics
  • Chesterfield, MO
National Provider Identifier
1093853145
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
2005015009 Issued in MO
Practice address
4 West Dr
Suite 160
Chesterfield, MO 63017-1793
Phone
(636) 778-9901
NPI assigned
Feb 1, 2007
Last updated
Mar 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 2005015009 MO Primary

Addresses

Primary practice location

4 West Dr
Suite 160
Chesterfield, MO 63017-1793

Mailing address

4 West Dr
Suite 160
Chesterfield, MO 63017-1793
Phone (636) 778-9901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150126002040 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3577887306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2005015009MOMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Eric M. Foss, D.D.S., M.S., P. C. Endodontics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1093853145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WEST DR",
            "address_2": "SUITE 160",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171793",
            "telephone_number": "636-778-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEST DR",
            "address_2": "SUITE 160",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171793",
            "telephone_number": "636-778-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSS",
        "first_name": "ERIC",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MO",
            "license": "2005015009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.