Individual provider Active NPI

Thomas M. Osmun, DMD

  • General Practice Dentistry
  • Fenton, MO
National Provider Identifier
1376671420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12146 Issued in MO
Practice address
170D Gravois Bluffs Cir
Fenton, MO 63026-7712
Phone
(636) 349-3434
Fax
(636) 349-5151
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12146 MO Primary

Addresses

Primary practice location

170D Gravois Bluffs Cir
Fenton, MO 63026-7712

Mailing address

170D Gravois Bluffs Cir
Fenton, MO 63026-7712
Phone (636) 349-3434

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12146MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376671420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170D GRAVOIS BLUFFS CIR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267712",
            "telephone_number": "636-349-3434",
            "fax_number": "636-349-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170D GRAVOIS BLUFFS CIR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267712",
            "telephone_number": "636-349-3434",
            "fax_number": "636-349-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSMUN",
        "first_name": "THOMAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.