Magdalena Bronakowska Mertz, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2021020472 Issued in MO

Practice address

1111 E 6TH St
Washington, MO 63090-3308

Phone

(636) 239-6328

NPI assigned

Jun 30, 2021

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  dba Chesterfield Park Dental

  • General Practice Dentistry
  • Chesterfield, MO
  • NPI 1013256452
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1205406287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E 6TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E 6TH ST",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903308",
            "telephone_number": "636-239-6328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 West Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630171793",
            "country_code": "US",
            "telephone_number": "636-532-1661",
            "fax_number": "866-262-1503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "MAGDALENA",
        "middle_name": "BRONAKOWSKA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2021020472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Hospitals East Communities (Mercy Hospital Washington)
• Mercy Labs Washington, LLC
• Mercy Pharmacy Services, LLC (Mercy Pharmacy Washington)
• Mercy Pharmacy Services, LLC (Mercy Pharmacy Patients First)
• Mercy Podiatry LLC
• Donna Ann Meyer, M.D./AP
• Sharise Meyer, CNM
• Michael J Pernoud DDS PC
• Michelle L. Beumer, PC (Riverside Pediatrics)
• Mid-America Dental Sleep Medicine LLC

• Dentist in Washington, MO
• Providers in Washington, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.