Mehulkumar Trivedi, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2024005484 Issued in MO

Practice address

733 Oakwood Dr
Fenton, MO 63026-3535

Phone

(636) 349-1070

NPI assigned

Sep 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Practice roles

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.

• Brookwood LLC

  • General Practice Dentistry
  • Fenton, MO
  • NPI 1134207459
  NPD (past)
• Edp of Missouri PC

  • Dental Clinic/Center
  • Creve Coeur, MO
  • NPI 1457867590
  NPD (past)

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1265801294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 SEABURY CIR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601884823",
            "telephone_number": "630-903-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 OAKWOOD DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263535",
            "telephone_number": "636-349-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "MEHULKUMAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-21",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040732",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021704",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21503",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002243",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.030588",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2024005484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Tiedemann, DPT
• Kyle Matthew Tiefel, D.C.
• Julia Titter, ATC
• Julie Toliusis, PHARMD
• Jamal Ngawashon Toure, PHARMD
• Scott Anthony Ulsas, D.C.
• Unique Milestones Behavior Services and Consultation LLC
• US Medgroup of Kansas PA
• Usrc Fenton LLC
• Suman Vaddi, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.