Individual provider Active NPI

Gilbert J Cyr Jr., DDS

  • Endodontics
  • St Louis, MO
National Provider Identifier
1295125474
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
014082 Issued in MO
Practice address
10777 Sunset Office Dr
Ste 100
St Louis, MO 63127
Phone
(314) 822-2210
NPI assigned
Jan 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 014082 MO Primary

Addresses

Primary practice location

10777 Sunset Office Dr
Ste 100
St Louis, MO 63127

Mailing address

6651 Chippewa St
Ste 323
St Louis, MO 63109-2532
Phone (314) 781-1919

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719002282 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1254624844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014082MOMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Endodontics Endodontics Past Accepting new patients
Southwest Endodontic Assoc. Endodontics 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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1295125474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6651 CHIPPEWA ST",
            "address_2": "STE 323",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631092532",
            "telephone_number": "314-781-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 SUNSET OFFICE DR",
            "address_2": "STE 100",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-822-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CYR",
        "first_name": "GILBERT",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MO",
            "license": "014082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.