Active NPI
Audra Louise O'Neal, RDH
- Dental Hygienist
- Potosi, MO
National Provider Identifier
1174890909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 2011018562
- Practice address
- 1 Southtowne Dr
Potosi, MO 63664-5729 - Phone
- (573) 438-8401
- NPI assigned
- Nov 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 2011018562 | MO | Primary |
Addresses
Primary practice location
1 Southtowne Dr
Potosi, MO 63664-5729
Mailing address
12445 Fieldstone Dr
Festus, MO 63028-5458
Phone (636) 579-0812
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2011018562 | MO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1174890909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12445 FIELDSTONE DR",
"city": "FESTUS",
"state": "MO",
"postal_code": "630285458",
"telephone_number": "636-579-0812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SOUTHTOWNE DR",
"city": "POTOSI",
"state": "MO",
"postal_code": "636645729",
"telephone_number": "573-438-8401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'NEAL",
"first_name": "AUDRA",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-22",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MO",
"license": "2011018562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Potosi, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.