Dipali D Thakker, DMD

Individual provider Active NPI General Practice Dentistry · O'Fallon, MO

NPI 1295828382 · NPPES record last updated Nov 12, 2025

Key facts

NPI
1295828382
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2012041115 (MO)
Practice address
2990 State Hwy K
O'Fallon, MO 63368
Phone
(636) 978-7816
Fax
(636) 215-2937
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2012041115MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Shaw Park Dental LLC Current Accepting new patients
Ronald Weems Jr. P.C. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dipali.thakker.p1@direct.affiniahealthcare.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2012041115 MO Yes

Addresses

Primary practice location

2990 State Hwy K
O'Fallon, MO 63368

Mailing address

2990 State Hwy K
O'Fallon, MO 63368
Phone (636) 978-7816

Other providers in O'Fallon, MO

All providers in O'Fallon, MO · General Practice Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.