Individual provider Active NPI

Tony W. McClure, D.D.S.

  • Pediatric Dentistry
  • Saint Louis, MO
National Provider Identifier
1346284445
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2011012490 Issued in MO
Practice address
3320 Rutger St
Saint Louis, MO 63104-1122
Phone
(314) 977-8363
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 128735 AK
Pediatric Dentistry 1223P0221X 2011012490 MO Primary

Addresses

Primary practice location

3320 Rutger St
Saint Louis, MO 63104-1122

Mailing address

11662 Gravois Rd Unit 8504
Saint Louis, MO 63126-4029
Phone (314) 717-1411

Other practice location 1

11662 Gravois Rd Unit 8504
Saint Louis, MO 63126-4029
Phone (314) 717-1411

Other practice location 2

12184 Natural Bridge Rd # 90
Bridgeton, MO 63044-2017
Phone (314) 391-4936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170608000066 TX Order and Referring Only - DentistPractitioner - Dentist 0042464182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
128735AKMDPediatric Dentist
2011012490MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium Current Accepting new patients
Blue Cloud Anesthesia, LLC Past Accepting new patients
St. Louis Children'S Surgery Center, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tmcclure558068@direct-ehr-ssmhc.com
  • Direct secure messaging: tmcclure@direct.scf.cc

Organizations & group practices 3

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1346284445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11662 GRAVOIS RD UNIT 8504",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631264029",
            "telephone_number": "314-717-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 RUTGER ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041122",
            "telephone_number": "314-977-8363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11662 Gravois Rd Unit 8504",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631264029",
            "country_code": "US",
            "telephone_number": "314-717-1411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12184 Natural Bridge Rd # 90",
            "address_purpose": "LOCATION",
            "city": "Bridgeton",
            "state": "MO",
            "postal_code": "630442017",
            "country_code": "US",
            "telephone_number": "314-391-4936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "TONY",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AK",
            "license": "128735",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2011012490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.