Perdita Jay Fisher, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

13373 Issued in MO

Practice address

11634 W Florissant Ave
Florissant, MO 63033-6723

Phone

(314) 837-9777

Fax

(314) 837-9778

NPI assigned

Sep 2, 2006

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

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215039987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11634 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336723",
            "telephone_number": "314-837-9777",
            "fax_number": "314-837-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11634 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336723",
            "telephone_number": "314-837-9777",
            "fax_number": "314-837-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "PERDITA",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "13373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Ann Finucane, OTR/L
• First Class Home Healthcare Services LLC
• Fisher Dental Center
• Kaylen Emily Fisher
• Ollie Christopher Fisher, DMD
• Five Star Rehabilitation and Wellness Services, LLC.
• Nicole Fix-Miller, BCBA, LBA
• Kelsey N Fix
• Danita Flakes, MSW, LCSW, ICADC
• Jonette Fleming

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

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.