Individual provider Active NPI

Louise R First

  • Dentist
  • St. Louis, MO
National Provider Identifier
1104066604
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
015538 Issued in MO
Practice address
77 Westport Plaza Drive
Suite 205
St. Louis, MO 63146
Phone
(314) 837-2120
Fax
(314) 838-8400
NPI assigned
Feb 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 015538 MO Primary

Addresses

Primary practice location

77 Westport Plaza Drive
Suite 205
St. Louis, MO 63146

Mailing address

77 W Port PLZ Ste 205
Saint Louis, MO 63146-3121
Phone (314) 837-2120

Other identifiers 1

IdentifierTypeStateIssuer
1174619514OtherMOBILLING NPI PRIVATE PRACTICE

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
015538MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Louise R First DMD PC Dentist CurrentSince Oct 27, 2019 Accepting new patients

Locations

77 West Port Plz
Ste 205
Saint Louis, MO 63146
Phone (314) 837-2120

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1104066604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W PORT PLZ STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463121",
            "telephone_number": "314-837-2120",
            "fax_number": "314-838-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WESTPORT PLAZA DRIVE",
            "address_2": "SUITE 205",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "63146",
            "telephone_number": "314-837-2120",
            "fax_number": "314-838-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIRST",
        "first_name": "LOUISE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "015538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BILLING NPI PRIVATE PRACTICE",
            "identifier": "1174619514",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.