Active NPI
Provide Dental
Doing business as Provide Dental- Chesterfield
- Dental Clinic/Center
- Chesterfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- PROVIDE DENTAL
- Doing business as
- Provide Dental- Chesterfield
- Practice address
- 13371 Olive Blvd # 3108
Chesterfield, MO 63017-3108 - Phone
- (314) 878-5544
- NPI assigned
- Sep 23, 2025
- Last updated
- Sep 23, 2025
- Organization subpart
- Yes
- Parent organization
- PROVIDE DENTAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Philip Son, DMD
- Title
- Dentist
- Phone
- (323) 787-9397
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
13371 Olive Blvd # 3108
Chesterfield, MO 63017-3108
Mailing address
13371 Olive Blvd # 3108
Chesterfield, MO 63017-3108
Phone (314) 878-5544
Other names 1
- Provide Dental- Chesterfield
National Provider Directory
National Provider Directory- Tax ID family
- Provide Dental
- Part of
- Provide Dental
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dental Clinic/Center
- Saint Louis, MO
- NPI 1760253694
-
dba Provide Dental- Chesterfield
- Dental Clinic/Center
- Chesterfield, MO
- NPI 1952292005
Locations
13371 Olive Blvd
#3108
Chesterfield, MO 63017
Phone (314) 878-5544
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Osage Beach, MO
- NPI 1124696083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758585600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758585600000",
"number": "1124990601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13371 OLIVE BLVD # 3108",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630173108",
"telephone_number": "314-878-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13371 OLIVE BLVD # 3108",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630173108",
"telephone_number": "314-878-5544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDE DENTAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PROVIDE DENTAL",
"enumeration_date": "2025-09-23",
"last_updated": "2025-09-23",
"certification_date": "2025-09-23",
"status": "A",
"authorized_official_last_name": "SON",
"authorized_official_first_name": "PHILIP",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "323-787-9397",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Provide Dental- Chesterfield",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chesterfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.