Ferguson Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FERGUSON DENTAL LLC

Practice address

46 S Florissant Rd
Ferguson, MO 63135-2334

Phone

(314) 522-6300

NPI assigned

Mar 30, 2011

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Victor L Clark, D.M.D.

Title

Dentist/Owner

Phone

(314) 522-6300

Specialties & licenses 1

Addresses

Locations

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.

• Michael Joseph Pernoud, D.D.S.

  • General Practice Dentistry
  • Ferguson, MO
  • NPI 1235338567
  NPD (past)

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1184913295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 S FLORISSANT RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631352334",
            "telephone_number": "314-522-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 S FLORISSANT RD",
            "city": "FERGUSON",
            "state": "MO",
            "postal_code": "631352334",
            "telephone_number": "314-522-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERGUSON DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "314-522-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Ferguson, MO
• Providers in Ferguson, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.