Active NPI
Justin Swain
- Dentist
- Ballwin, MO
National Provider Identifier
1437564770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2014018763
- Practice address
- 13603 Barrett Office Dr
Suite 104
Ballwin, MO 63021-7828 - Phone
- (314) 822-3868
- NPI assigned
- Jun 25, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2014018763 | MO | Primary |
Addresses
Primary practice location
13603 Barrett Office Dr
Suite 104
Ballwin, MO 63021-7828
Mailing address
13603 Barrett Office Dr
Suite 104
Ballwin, MO 63021-7828
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2014018763 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kleitz DMD Richardson DMD PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Des Peres Dental Group Inc
- General Practice Dentistry
- St Louis, MO
- NPI 1912056151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403654400000",
"number": "1437564770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13603 BARRETT OFFICE DR",
"address_2": "SUITE 104",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13603 BARRETT OFFICE DR",
"address_2": "SUITE 104",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217828",
"telephone_number": "314-822-3868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAIN",
"first_name": "JUSTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2014-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2014018763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.