Individual provider Active NPI

Stephen Charles Snitzer, D.D.S.

  • Periodontics
  • Chesterfield, MO
National Provider Identifier
1194720243
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
13020 Issued in MO
Practice address
14377 Woodlake Dr
Ste 214
Chesterfield, MO 63017-5735
Phone
(314) 434-2101
Fax
(314) 434-2361
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 13020 MO Primary

Addresses

Primary practice location

14377 Woodlake Dr
Ste 214
Chesterfield, MO 63017-5735

Mailing address

14377 Woodlake Dr
Ste 214
Chesterfield, MO 63017-5735
Phone (314) 434-2101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20140721000038 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133345606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13020MOMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Elizabeth Doyle Binz DDS Ms LLC Periodontics PastSince Jan 2, 2022 Accepting new patients
Stephen C. Snitzer, D.D.S., M.S., P.C. Periodontics Past Accepting new patients

Organizations & group practices 2

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194720243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "STE 214",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-434-2101",
            "fax_number": "314-434-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR",
            "address_2": "STE 214",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-434-2101",
            "fax_number": "314-434-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNITZER",
        "first_name": "STEPHEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "13020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.