St. Louis County Dental Partnership, Timothy M Grayem DDS & Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2002013144 Issued in MO

Legal business name

ST. LOUIS COUNTY DENTAL PARTNERSHIP, TIMOTHY M GRAYEM DDS & ASSOCIATES

Practice address

469 S Kirkwood Rd
Kirkwood, MO 63122-6119

Phone

(314) 965-6503

Fax

(314) 965-7417

NPI assigned

Jul 25, 2016

Organization subpart

No

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

Authorized official

Name

Janice E Pelley

Title

Practice Manager

Phone

(314) 965-6503

Specialties & licenses 1

Addresses

Practitioners 2

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

• Daniel Bialecki, DDS

  • Dentist
  • Kirkwood, MO
  • NPI 1891902656
  NPD (past)
• Christine F Lathuras, DDS

  • Dentist
  • Kirkwood, MO
  • NPI 1619031788
  NPD (past)

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1447703590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226119",
            "telephone_number": "314-965-6503",
            "fax_number": "314-965-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 S KIRKWOOD RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226119",
            "telephone_number": "314-965-6503",
            "fax_number": "314-965-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS COUNTY DENTAL PARTNERSHIP, TIMOTHY M GRAYEM DDS & ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "PELLEY",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "314-965-6503"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2002013144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Agnes Home
• St Louis Specialty Surgical Center LLC
• St. Anthony'S Physician Organization
• St. Louis Cardiovascular Institute, LLC
• St. Louis Cardiovascular Institute, LLC
• St. Louis Eating Recovery Therapy, LLC
• Patrick Charles Stack, D.MIN
• Janet Elizabeth Staicoff, RD
• Brandon Cory Steele, DC
• Kristina Marie Steen, MSW

• General Practice Dentistry in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.