Active NPI
Adam Birk, DMD
- Dentist
- Saint Louis, MO
National Provider Identifier
1386050631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2015020290
- Practice address
- 77 W Port PLZ Ste 251
Saint Louis, MO 63146-3121 - Phone
- (314) 434-7300
- NPI assigned
- Jul 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2015020290 | MO | Primary |
Addresses
Primary practice location
77 W Port PLZ Ste 251
Saint Louis, MO 63146-3121
Mailing address
9873 Grantview Forest Drive
St. Louis, MO 63123
Phone (618) 410-6016
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015020290 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westport Dental LLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Saint Louis, MO
- NPI 1467983973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1386050631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9873 GRANTVIEW FOREST DRIVE",
"city": "ST. LOUIS",
"state": "MO",
"postal_code": "63123",
"telephone_number": "618-410-6016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 W PORT PLZ STE 251",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631463121",
"telephone_number": "314-434-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIRK",
"first_name": "ADAM",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-08",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2015020290",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.