NPIMap

Organization Active NPI

Soh of Missouri Samson Liu PC

Doing business as Lindbergh Dental & Orthodontics

  • Dentist
  • Florissant, MO
National Provider Identifier
1114503067
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SOH OF MISSOURI SAMSON LIU PC
Doing business as
Lindbergh Dental & Orthodontics
Practice address
111 N Highway 67 St
Florissant, MO 63031-5901
Phone
(636) 362-4986
NPI assigned
Mar 22, 2021
Organization subpart
Yes
Parent organization
SOH OF MISSOURI SAMSON LIU PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Ashly Kristine Sunshine
Title
Credentialing Specialist
Phone
(314) 413-2803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

111 N Highway 67 St
Florissant, MO 63031-5901

Mailing address

111 N Highway 67 St
Florissant, MO 63031-5901

Other names 1

  • Lindbergh Dental & Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Soh of Missouri Samson PC6 organizations share this tax ID, including this one
Part of
Soh of Missouri Samson PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

111 N Highway 67 St
Florissant, MO 63031
Phone (314) 408-8390

NPI Registry JSON

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1114503067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N HIGHWAY 67 ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N HIGHWAY 67 ST",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315901",
            "telephone_number": "636-362-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOH OF MISSOURI SAMSON LIU PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOH OF MISSOURI SAMSON LIU PC",
        "enumeration_date": "2021-03-22",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "SUNSHINE",
        "authorized_official_first_name": "ASHLY",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "314-413-2803"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lindbergh Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.