Kristen Watts, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2020038493 Issued in MO

Practice address

2958 Dougherty Ferry Rd
Saint Louis, MO 63122-3366

Phone

(636) 394-4275

NPI assigned

Apr 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1164041588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1238 ARCH TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2958 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223366",
            "telephone_number": "636-394-4275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATTS",
        "first_name": "KRISTEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2020038493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "095967151",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "kristen.watts@nyulangone.org",
            "affiliation": "N",
            "endpointDescription": "Resident/School Associated Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "150 55th St",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112202508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drwatts@polishedsmiles.com",
            "affiliation": "N",
            "endpointDescription": "work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2958 Dougherty Ferry Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631223366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Zachary Wattles, DO
• Andrea J Watts, PT
• Anna Dawn Watts, DPT
• Brooke Watts, FNP
• Daniel Watts, PHARM.D.
• Patrina Letise Watts, LPN
• Chiedozie Ikenna Anochi Waturuocha, MD
• Isabel Ann Watz
• Courtney Elizabeth Watza
• Donovan Watza, MD, PHD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.