Active NPI
George Mackay Coleman Jr., D.M.D.
- Dentist
- Florissant, MO
National Provider Identifier
1275629909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 013199
- Practice address
- 14220 Old Halls Ferry Road
Suite 100
Florissant, MO 63034 - Phone
- (314) 355-2838
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 013199 | MO | Primary |
Addresses
Primary practice location
14220 Old Halls Ferry Road
Suite 100
Florissant, MO 63034
Mailing address
3739 Elm St
Suite 100
Saint Charles, MO 63301-4345
Phone (636) 443-2329
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160311000955 | MO | Order and Referring Only - Oral Surgery | 9830495167 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456876800000",
"number": "1275629909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3739 ELM ST",
"address_2": "SUITE 100",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633014345",
"telephone_number": "636-443-2329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14220 OLD HALLS FERRY ROAD",
"address_2": "SUITE 100",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "63034",
"telephone_number": "314-355-2838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "GEORGE",
"middle_name": "MACKAY",
"name_suffix": "Jr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2016-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "013199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.