Courtney Ethington, DMD, MSD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2019043361 Issued in MO

Practice address

4 West Dr Ste 170
Chesterfield, MO 63017-1793

Phone

(636) 778-9345

NPI assigned

Dec 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chesterfield-Bankhead DDS Orthodontics PC

  dba Chesterfield Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chesterfield, MO
  • NPI 1952559866
  NPD (past)
• Bankhead Alton Orthodontics PC

  dba Heintz and Bankhead Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Alton, IL
  • NPI 1740812494
  NPD (past)

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1134767866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 E LINDEN AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEST DR STE 170",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171793",
            "telephone_number": "636-778-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHINGTON",
        "first_name": "COURTNEY",
        "credential": "DMD, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019.032433",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2019043361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DENTAL LICENSE",
            "identifier": "019.032433",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI DENTAL LICENSE",
            "identifier": "2019043361",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "courtneyethington@bankheadortho.com",
            "affiliation": "N",
            "address_1": "4 West Dr Ste 170",
            "city": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630171793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ernstrom Spinal Rehab LLC
• Edward J Ernstrom, D.C.
• Michael A Essner, DPT
• Sarah Christine Esswein, PLPC
• James H. Esther, M.D.
• Neil Ettinger, MD
• Eugenia Kardaris (New Age Dental Care)
• Evan W Brown DDS Inc
• Emily Louise Evans, MD
• Endurance Osas Evbayekha, MD

• Oral and Maxillofacial Surgery (Dentist) in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

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