Borello Orthodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2008019644 Issued in MO

Legal business name

BORELLO ORTHODONTICS

Practice address

6288 Ronald Reagan Dr.
Lake Saint Louis, MO 63367

Phone

(636) 625-4224

NPI assigned

Sep 23, 2010

Last updated

Feb 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Blake Borello, D.D.S., M.S.NPI 1902114515

Title

Owner

Phone

(636) 625-4224

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Blake Borello, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake Saint Louis, MO
  • NPI 1902114515
  NPD (past) Authorized official
• Taylor Little, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lake St Louis, MO
  • NPI 1558123364
  NPD (past)

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

{
    "created_epoch": "1285200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1326356304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 SAINT CHARLES ST",
            "address_2": "APT. 5A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031963",
            "telephone_number": "636-625-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6288 RONALD REAGAN DR.",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "63367",
            "telephone_number": "636-625-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORELLO ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-23",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "BORELLO",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-625-4224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MO",
            "license": "2008019644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Baxter
• Ross Matthew Belew, PHARMD
• Kristin Bemis
• Donald Beussink
• Kieara Bond, RN
• Blake Borello, D.D.S., M.S.
• Brain to Behavior LLC
• Michelle Lynn Breneman, PNP
• Bright Horizons Pediatric Therapy LLC
• By Word and Deed LLC

• Dental Clinic/Center in Lake Saint Louis, MO
• Providers in Lake Saint Louis, MO by specialty
• Dental Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.