Individual provider Active NPI

Jacob Earl Sonn, D.M.D.

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1174906242
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20117002646 Issued in MO
Practice address
9000 Watson Rd Ste 101
Saint Louis, MO 63126-2217
Phone
(314) 842-7500
Fax
(314) 842-8401
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20117002646 MO Primary
Dentist 122300000X DN 21412 FL

Addresses

Primary practice location

9000 Watson Rd Ste 101
Saint Louis, MO 63126-2217

Mailing address

9000 Watson Rd Ste 101
Saint Louis, MO 63126-2217
Phone (314) 842-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170817001835 MO Order and Referring Only - DentistPractitioner - Dentist 2961774427

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 21412FLMDDentist
20117002646MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Sonn DMD LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

9000 Watson Rd
Ste 101
Saint Louis, MO 63126
Phone (314) 842-7500

Organizations & group practices 1

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": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1174906242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 WATSON RD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262217",
            "telephone_number": "314-842-7500",
            "fax_number": "314-842-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WATSON RD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262217",
            "telephone_number": "314-842-7500",
            "fax_number": "314-842-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONN",
        "first_name": "JACOB",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "20117002646",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.