Sherri Lin Poettker, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2003000402 Issued in MO

Practice address

3090 Winghaven Blvd
O Fallon, MO 63368

Phone

(636) 561-0800

Fax

(636) 625-0088

NPI assigned

Oct 5, 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

Other names 1

• Miss Sherri Lin Meyer Other name

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

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.

• Sherri Poettker DMD LLC

  dba Lakeside Dental

  • Dentist
  • O'Fallon, MO
  • NPI 1144426214
  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306933171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 WINGHAVEN BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "63368",
            "telephone_number": "636-561-0800",
            "fax_number": "636-625-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 WINGHAVEN BLVD",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "63368",
            "telephone_number": "636-561-0800",
            "fax_number": "636-625-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POETTKER",
        "first_name": "SHERRI",
        "middle_name": "LIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2003000402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRI",
            "last_name": "MEYER",
            "middle_name": "LIN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Wayne Platt, MA MSW
• Play All Day Pediatric Therapy LLC
• Jennifer A. Plessner, D.D.S.
• Gwenda Marie Plummer, LPC
• Jessica Plut, P.T.
• Jennifer Lynn Ponder
• Nicole Pondrom, LMSW
• Blake Ponist, OT
• Abigail Pope, CNM
• Anthony S Pope, DPT

• Dentist in O'Fallon, MO
• Providers in O'Fallon, 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.