Individual provider Active NPI

Justin K Fox, DDS

  • General Practice Dentistry
  • Dardenne Prairie, MO
National Provider Identifier
1134611494
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2018017601 Issued in MO
Practice address
1032 Rondale CT
Dardenne Prairie, MO 63368-7368
Phone
(636) 949-2587
NPI assigned
Jun 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2018017601 MO Primary

Addresses

Primary practice location

1032 Rondale CT
Dardenne Prairie, MO 63368-7368

Mailing address

8100 Southpark CT
Saint Louis, MO 63125-1012
Phone (314) 775-4251

Other practice location 1

1171 Scenic Dr
Herculaneum, MO 63048-1406
Phone (636) 479-5324

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
2018017601MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Scenic Drive Dental Center Past Accepting new patients
Wojtyna DDS LLC General Practice Past Accepting new patients
Expressions Dental Group General Practice PastSince Sep 13, 2020 Accepting new patients
Wojtyna DDS II LLC General Practice PastSince May 8, 2022 Accepting new patients

Organizations & group practices 4

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": "1527984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1134611494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 SOUTHPARK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631251012",
            "telephone_number": "314-775-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 RONDALE CT",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633687368",
            "telephone_number": "636-949-2587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1171 Scenic Dr",
            "address_purpose": "LOCATION",
            "city": "Herculaneum",
            "state": "MO",
            "postal_code": "630481406",
            "country_code": "US",
            "telephone_number": "636-479-5324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOX",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-03",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018017601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dardenne Prairie, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.