Individual provider Active NPI

Craig Stephen Hollander, D.D.S.

  • Pediatric Dentistry
  • Saint Louis, MO
National Provider Identifier
1407876493
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2006012264 Issued in MO
Practice address
3555 Sunset Office Dr
Suite 210
Saint Louis, MO 63127-1015
Phone
(314) 822-2764
Fax
(314) 822-5758
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2006012264 MO Primary

Addresses

Primary practice location

3555 Sunset Office Dr
Suite 210
Saint Louis, MO 63127-1015

Mailing address

3555 Sunset Office Dr
Suite 210
Saint Louis, MO 63127-1015
Phone (314) 822-2764

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150827001841 MO Practitioner - Oral Surgery 0244546869 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006012264MOMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities CurrentSince Jul 25, 2015 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 25, 2015 Accepting new patients
Mercy Clinic East Communities Past Accepting new patients
WM. Gerald Albrecht, DDS PC Pediatric Dentistry Past Accepting new patients
E. Brown, DDS, C. Hollander, DDS, M. Fernandez, DDS, D. Autry, DMD LLC Pediatric Dentistry Past Accepting new patients

Locations

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407876493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271015",
            "telephone_number": "314-822-2764",
            "fax_number": "314-822-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 SUNSET OFFICE DR",
            "address_2": "SUITE 210",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271015",
            "telephone_number": "314-822-2764",
            "fax_number": "314-822-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "CRAIG",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2006012264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.