NPIMap

Organization Active NPI

Missouri Dental Professionals, Richard Straus, D.M.D., P.C.

Doing business as Forum Dental - St. Peters

  • General Practice Dentistry
  • Saint Peters, MO
National Provider Identifier
1376149237
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, D.M.D., P.C.
Doing business as
Forum Dental - St. Peters
Practice address
340 Mid Rivers Mall Dr Ste E
Saint Peters, MO 63376-1581
Phone
(636) 279-1633
NPI assigned
Dec 7, 2020
Last updated
Dec 7, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, D.M.D., P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Tabatha Lemke
Title
Credentialing Coordinator
Phone
(217) 540-6078

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

340 Mid Rivers Mall Dr Ste E
Saint Peters, MO 63376-1581

Mailing address

340 Mid Rivers Mall Dr Ste E
Saint Peters, MO 63376-1581

Other names 1

  • Forum Dental - St. Peters Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC60 organizations share this tax ID, including this one
Part of
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

340 Mid Rivers Mall Dr
Ste E
Saint Peters, MO 63376
Phone (636) 279-1633

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1376149237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MID RIVERS MALL DR STE E",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MID RIVERS MALL DR STE E",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761581",
            "telephone_number": "636-279-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, D.M.D., P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, D.M.D., P.C.",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-04",
        "status": "A",
        "authorized_official_last_name": "LEMKE",
        "authorized_official_first_name": "TABATHA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-6078"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forum Dental - St. Peters",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.