NPIMap

Organization Active NPI

NA Niewdach Inc

  • Dental Clinic/Center
  • Des Peres, MO
National Provider Identifier
1184196305
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NA NIEWDACH INC
Practice address
11648 Manchester Rd
Des Peres, MO 63131-4612
Phone
(314) 394-2828
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Authorized official

Name
Nicole NiewdachNPI 1427216597
Title
Owner
Phone
(314) 394-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

11648 Manchester Rd
Des Peres, MO 63131-4612

Mailing address

11648 Manchester Rd
Des Peres, MO 63131-4612

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545955200000",
    "number": "1184196305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11648 MANCHESTER RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631314612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11648 MANCHESTER RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631314612",
            "telephone_number": "314-394-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NA NIEWDACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A",
        "authorized_official_last_name": "NIEWDACH",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-394-2828"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.