Individual provider Active NPI

Alexander Wojtyna, DDS

  • Dentist
  • Saint Peters, MO
National Provider Identifier
1316078132
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2005031155 Issued in MO
Practice address
1325 Queens CT
Suite B
Saint Peters, MO 63376-7375
Phone
(636) 928-4441
Fax
(636) 922-3665
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2005031155 MO Primary

Addresses

Primary practice location

1325 Queens CT
Suite B
Saint Peters, MO 63376-7375

Mailing address

1325 Queens CT
Suite B
Saint Peters, MO 63376-7375
Phone (636) 928-4441

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
I20170731002726 MO Order and Referring Only - DentistPractitioner - Dentist 3476857780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005031155MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Missouri Dental Professionals, Richard Straus, DMD, PC Past Accepting new patients

Organizations & group practices 1

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316078132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 QUEENS CT",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767375",
            "telephone_number": "636-928-4441",
            "fax_number": "636-922-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 QUEENS CT",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633767375",
            "telephone_number": "636-928-4441",
            "fax_number": "636-922-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJTYNA",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2005031155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.