Active NPI
Heather Lea Zieba, DMD
- Dentist
- Ellisville, MO
National Provider Identifier
1184638744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2000165488
- Practice address
- 16111 Manchester Road
Suite 202
Ellisville, MO 63011 - Phone
- (636) 391-6030
- Fax
- (636) 527-8386
- NPI assigned
- Jul 28, 2006
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2000165488 | MO | Primary |
Addresses
Primary practice location
16111 Manchester Road
Suite 202
Ellisville, MO 63011
Mailing address
16111 Manchester Road
Suite 202
Ellisville, MO 63011
Phone (636) 391-6030
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 |
|---|---|---|---|
| 2000165488 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184638744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16111 MANCHESTER ROAD",
"address_2": "SUITE 202",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "63011",
"telephone_number": "636-391-6030",
"fax_number": "636-527-8386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16111 MANCHESTER ROAD",
"address_2": "SUITE 202",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "63011",
"telephone_number": "636-391-6030",
"fax_number": "636-527-8386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZIEBA",
"first_name": "HEATHER",
"middle_name": "LEA",
"name_prefix": "Mrs.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2000165488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.