Marissa Gardner, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2901602898 Issued in MI

Practice address

1500 Park Ave
Saint Louis, MO 63104-3024

Phone

(314) 252-8196

NPI assigned

Jun 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782432000000",
    "number": "1376388835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 11TH AVE S",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293005",
            "telephone_number": "906-241-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PARK AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043024",
            "telephone_number": "314-252-8196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498294201",
            "country_code": "US",
            "telephone_number": "906-233-9477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 Ludington St",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498292344",
            "country_code": "US",
            "telephone_number": "906-786-4033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1103 Delta Ave",
            "address_purpose": "LOCATION",
            "city": "Gladstone",
            "state": "MI",
            "postal_code": "498371438",
            "country_code": "US",
            "telephone_number": "906-428-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MARISSA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2026-06-26",
        "certification_date": "2026-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.sanford.html",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1500 Park Ave",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631043024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erin Scott Gardner, M.D.
• Gary John Gardner, N.P.
• Gina Lisette Gardner, NP
• Kari Gardner, NP
• Laura J Gardner, MD
• Morey Gardner, M.D.
• Namibia Qadir Gardner, LPN
• Rebecca Ella Gardner, NP-C
• Rita Gardner, ANP
• Sandra Yvonne Gardner

• Dentist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2026; 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.