Active NPI
Latasha Nicole Nash, D.M.D
- General Practice Dentistry
- Florissant, MO
National Provider Identifier
1407134455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2011020304
- Practice address
- 13410 New Halls Ferry Rd
Florissant, MO 63033-3035 - Phone
- (314) 830-9663
- Fax
- (314) 830-9664
- NPI assigned
- Jul 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2011020304 | MO | Primary |
| General Practice Dentistry | 1223G0001X | 019.028729 | IL |
Addresses
Primary practice location
13410 New Halls Ferry Rd
Florissant, MO 63033-3035
Mailing address
9378 Olive Blvd
Suite Ill
Olivette, MO 63132-3215
Phone (314) 872-3930
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 |
|---|---|---|---|
| 019.028729 | IL | MD | General Practice Dentistry |
| 2011020304 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The W Dental Group | Past | Accepting new patients | |
| Children'S Dental Zone | Past | Accepting new patients | |
| Gateway Oral Health Foundation | General Practice | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dental Clinic/Center
- Florissant, MO
- NPI 1700172806
-
- General Practice Dentistry
- Olivette, MO
- NPI 1346394970
-
- Dental Clinic/Center
- Florissant, MO
- NPI 1477840387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312502400000",
"number": "1407134455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9378 OLIVE BLVD",
"address_2": "SUITE ILL",
"city": "OLIVETTE",
"state": "MO",
"postal_code": "631323215",
"telephone_number": "314-872-3930",
"fax_number": "314-872-3952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13410 NEW HALLS FERRY RD",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630333035",
"telephone_number": "314-830-9663",
"fax_number": "314-830-9664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "LATASHA",
"middle_name": "NICOLE",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-25",
"last_updated": "2011-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2011020304",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IL",
"license": "019.028729",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Florissant, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.