NPIMap

Organization Active NPI

St Louis Childrens General Anesthesia Dentistry, LLC

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1417890963
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ST LOUIS CHILDRENS GENERAL ANESTHESIA DENTISTRY, LLC
Practice address
12101 Woodcrest Executive Dr Ste 101
Saint Louis, MO 63141-5047
Phone
(301) 494-3000
NPI assigned
Apr 10, 2026
Last updated
Apr 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Authorized official

Name
Jeff Wheeler
Title
Ceo
Phone
(301) 494-3000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary
Pediatric Anesthesiology Physician 207LP3000X NU

Addresses

Primary practice location

12101 Woodcrest Executive Dr Ste 101
Saint Louis, MO 63141-5047

Mailing address

12101 Woodcrest Executive Dr Ste 101
Saint Louis, MO 63141-5047

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777420800000",
    "number": "1417890963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 WOODCREST EXECUTIVE DR STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415047",
            "telephone_number": "301-494-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS CHILDRENS GENERAL ANESTHESIA DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-494-3000"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Apr 29, 2026; 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.