NPIMap

Organization Active NPI

Nicholas P Kamakas, DDS

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1396918140
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12839 Issued in MO
Legal business name
NICHOLAS P KAMAKAS, DDS
Practice address
1167 Remley CT
Saint Louis, MO 63130-2135
Phone
(314) 727-7435
Fax
(314) 727-7003
NPI assigned
Apr 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Dr. Nicholas P Kamakas
Title
Owner
Phone
(314) 727-7435

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 010913 MO
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12839 MO Primary

Addresses

Primary practice location

1167 Remley CT
Saint Louis, MO 63130-2135

Mailing address

1167 Remley CT
Saint Louis, MO 63130-2135
Phone (314) 727-7435

Other identifiers 3

IdentifierTypeStateIssuer
400367900MedicaidMO
403293921MedicaidMO
408996403MedicaidMO

National Provider Directory

National Provider Directory

Locations

1167 Remley Ct
Saint Louis, MO 63130
Phone (314) 727-7435

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1396918140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 REMLEY CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631302135",
            "telephone_number": "314-727-7435",
            "fax_number": "314-727-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1167 REMLEY CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631302135",
            "telephone_number": "314-727-7435",
            "fax_number": "314-727-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS P KAMAKAS, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "KAMAKAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-727-7435",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "010913",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400367900",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403293921",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408996403",
            "state": "MO"
        }
    ],
    "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 Mar 24, 2015; 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.