Mahoney and Ballard DMD Inc

Primary specialty

DentistTaxonomy code 122300000X

License

9210 Issued in MO

Legal business name

MAHONEY AND BALLARD DMD INC

Practice address

720 Olive Street
Suite 1700
Saint Louis, MO 63101

Phone

(314) 241-4232

Fax

(314) 241-3204

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Pauline R Ray

Title

Office Manager

Phone

(314) 241-4232

Specialties & licenses 1

Addresses

Other names 1

• Downtown Dental Associates Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joel Gary Luedeke, D.M.D.

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1679695118
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104049618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLIVE STREET",
            "address_2": "SUITE 1700",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63101",
            "telephone_number": "314-241-4232",
            "fax_number": "314-241-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 OLIVE STREET",
            "address_2": "SUITE 1700",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63101",
            "telephone_number": "314-241-4232",
            "fax_number": "314-241-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHONEY AND BALLARD DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-241-4232",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "9210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downtown Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shafaq Mahmoud, M.B.,B.S.
• Shamseldeen Younes Mohamed Mahmoud, M.D
• Zainab Mahmoud, MD
• Gerald Mahon, M.D.
• Suzanne Marie Mahon, RN DNSC AOCN APNG
• Kari Mahoney
• Kathleen Elizabeth Mahoney, MD
• Kevin R Mahoney, MD
• Lindsey Mahoney, MD
• Robert J Mahoney, MD

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.