Organization Active NPI

Danny M Gennaoui DMD LLC

  • Dental Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1417612904
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DANNY M GENNAOUI DMD LLC
Practice address
3701 S Lindbergh Blvd Ste 200
Saint Louis, MO 63127-1372
Phone
(314) 821-4410
NPI assigned
Nov 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Authorized official

Name
Tara Rees
Title
Treatment Coordinator
Phone
(314) 821-4410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3701 S Lindbergh Blvd Ste 200
Saint Louis, MO 63127-1372

Mailing address

3701 S Lindbergh Blvd Ste 200
Saint Louis, MO 63127-1372
Phone (314) 821-4410

Other identifiers 1

IdentifierTypeStateIssuer
1518214782OtherNPI TYPE 1

Other names 1

  • Gennaoui Family Dental Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address office@gennaoui.dental

National Provider Directory

National Provider Directory

Locations

3701 S Lindbergh Blvd
Ste 200
Saint Louis, MO 63127
Phone (314) 821-4410

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1417612904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 S LINDBERGH BLVD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271372",
            "telephone_number": "314-821-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 S LINDBERGH BLVD STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271372",
            "telephone_number": "314-821-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANNY M GENNAOUI DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "REES",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "TREATMENT COORDINATOR",
        "authorized_official_telephone_number": "314-821-4410"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1518214782",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@gennaoui.dental",
            "affiliation": "N",
            "address_1": "3701 S Lindbergh Blvd Ste 200",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631271372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gennaoui Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 1, 2021; 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.