Individual provider Active NPI

Robert E. Hawkins, D.M.D.

  • Oral and Maxillofacial Pathology Dentistry
  • Saint Peters, MO
National Provider Identifier
1417007600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
13201 Issued in MO
Practice address
4201 S Cloverleaf Dr
B
Saint Peters, MO 63376-6438
Phone
(636) 928-0209
Fax
(636) 928-0274
NPI assigned
Jan 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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
Oral and Maxillofacial Pathology Dentistry 1223P0106X 13201 MO Primary

Addresses

Primary practice location

4201 S Cloverleaf Dr
B
Saint Peters, MO 63376-6438

Mailing address

4201 S Cloverleaf Dr
Q
Saint Peters, MO 63376-6438
Phone (636) 928-0209

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

LicenseStateTypeSpecialty
13201MOMDOral and Maxillofacial Pathology Dentist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417007600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 S CLOVERLEAF DR",
            "address_2": "Q",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766438",
            "telephone_number": "636-928-0209",
            "fax_number": "636-928-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 S CLOVERLEAF DR",
            "address_2": "B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766438",
            "telephone_number": "636-928-0209",
            "fax_number": "636-928-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MO",
            "license": "13201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.