Active NPI
Jacob Earl Sonn, D.M.D.
- General Practice Dentistry
- Saint Louis, MO
National Provider Identifier
1174906242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 20117002646
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170817001835 | MO | Order and Referring Only - Dentist | 2961774427 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN 21412 | FL | MD | Dentist |
| 20117002646 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacob Sonn DMD LLC | Current | 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.
-
- Dental Clinic/Center
- Saint Louis, MO
- NPI 1437933140
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.