Michael W Noble, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

019019361 Issued in IL

Practice address

10200 W Main St
Belleville, IL 62223-1408

Phone

(618) 397-2464

Fax

(618) 398-4450

NPI assigned

Oct 27, 2005

Last updated

Feb 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 27, 2021 through May 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral Facial Surgery Institute of Illinois P C

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1740697333

  Single Specialty

  NPD
• Center for Oral and Maxillofacial Surgery, P.C.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1801000443

  Single Specialty

  NPD (past)
• Mercy Support Services

  dba Mercy JFK Clinic

  • Clinic/Center
  • Saint Louis, MO
  • NPI 1265572812

  Single Specialty

  NPD (past)
• St. John's Mercy Support Services

  • Cardiovascular Disease Physician
  • Washington, MO
  • NPI 1912020397

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1356331672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231408",
            "telephone_number": "618-400-6725",
            "fax_number": "618-500-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231408",
            "telephone_number": "618-397-2464",
            "fax_number": "618-398-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11710 Old Ballas Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631417076",
            "country_code": "US",
            "telephone_number": "314-866-6725",
            "fax_number": "314-998-6725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "14929",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019019361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela J Nicholson, RD, LDN
• Joshua A. Niebruegge, M.D.
• Christopher Nier
• Jayne E. Ninness, LPTA
• Catherine Elizabeth Noble, M.D.
• Samantha Kay Noeth, MMSN
• David C Norman, MD
• Lauren G Norrenberns, CPNP-PC
• Lynne Nowak, MD
• Nurturing by Faith Home Care, LLC

• Oral and Maxillofacial Surgery (Dentist) in Belleville, IL
• Providers in Belleville, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.