Michael J Backer, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2016006250 Issued in MO

Practice address

17300 Outer 40 Rd N.
Suite 103
Chesterfield, MO 63005

Phone

(636) 536-5158

Fax

(636) 536-4544

NPI assigned

Apr 15, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 11, 2016 through Jul 11, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: michael.backer.p1@direct.affiniahealthcare.nextgenshare.com

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.

• Michael K Parsons DDS PC

  dba Midwest Oral and Maxillo Facial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • O'Fallon, MO
  • NPI 1457484222
  NPD (past)

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

{
    "created_epoch": "1334448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1427315431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 OUTER 40 RD N.",
            "address_2": "SUITE 103",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-536-5158",
            "fax_number": "636-536-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 OUTER 40 RD N.",
            "address_2": "SUITE 103",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63005",
            "telephone_number": "636-536-5158",
            "fax_number": "636-536-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-15",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2016006250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Elizabeth Azinger, PA
• Alison Elizabeth Babb, OTR/L
• Kathleen Denise Bachman, P.T.
• Kathryn Rebecca Bachman, PA-C
• Mary S Backer-Conklin, SLP
• Marisa Evens Badamo, SLP
• Ella Baderman
• Bettina Monica Badoy, DPT
• Kelly Ann Baer
• Mahesh R Bagwe, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.