Active NPI
Rebeecca Feitosa Da Fonte
- Dentist
- Saint Louis, MO
National Provider Identifier
1407689201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2024029090
- Practice address
- 22 N Euclid Ave Ste 220
Saint Louis, MO 63108-1407 - Phone
- (314) 367-7702
- NPI assigned
- Aug 26, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2024029090 | MO | Primary |
Addresses
Primary practice location
22 N Euclid Ave Ste 220
Saint Louis, MO 63108-1407
Mailing address
22 N Euclid Ave Ste 220
Saint Louis, MO 63108-1407
Phone (314) 367-7702
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 |
|---|---|---|---|
| 2024029090 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1407689201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 N EUCLID AVE STE 220",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631081407",
"telephone_number": "314-367-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 N EUCLID AVE STE 220",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631081407",
"telephone_number": "314-367-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DA FONTE",
"first_name": "REBEECCA",
"middle_name": "FEITOSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-26",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2024029090",
"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 Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.