Individual provider Active NPI

Kevin Joseph Price, D.D.S.

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1417266776
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2010016309 Issued in MO
Practice address
439 S Kirkwood Rd
Suite 211
Saint Louis, MO 63122-6169
Phone
(314) 965-5551
NPI assigned
Oct 4, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2010016309 MO Primary

Addresses

Primary practice location

439 S Kirkwood Rd
Suite 211
Saint Louis, MO 63122-6169

Mailing address

9206 Lawndale Dr
Saint Louis, MO 63126-2618

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
2010016309MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1417266776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9206 LAWNDALE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631262618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 S KIRKWOOD RD",
            "address_2": "SUITE 211",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226169",
            "telephone_number": "314-965-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICE",
        "first_name": "KEVIN",
        "middle_name": "JOSEPH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2010016309",
            "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 Oct 4, 2010; 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.