Jane Allison Otto, M.A.M.S., D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

016009 Issued in MO

Practice address

11624 Gravois Rd
Saint Louis, MO 63126-3014

Phone

(314) 842-2442

Fax

(314) 842-2467

NPI assigned

Aug 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386651685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11624 GRAVOIS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263014",
            "telephone_number": "314-842-2442",
            "fax_number": "314-842-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11624 GRAVOIS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631263014",
            "telephone_number": "314-842-2442",
            "fax_number": "314-842-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "JANE",
        "middle_name": "ALLISON",
        "name_prefix": "Dr.",
        "credential": "M.A.M.S.,  D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "016009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Jean Otten, PT
• Olivia Renee Otten
• Kristen Anne Ottenlips, MA CF-SLP
• Otto Bock Patient Care, LLC
• Andrea Shae Otto, M.D.
• Thomas Otto, MD
• Lisa A Ottolini, MSW, LCSW
• Megan Ottomeyer, D.O
• Robyn Otty, OTD, OTR/L
• Jiafu Ou, MD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.