NPIMap

Organization Active NPI

Nikodem Dental Holdings, Inc.

Doing business as Nikodem Dental Hazelwood

  • Dental Clinic/Center
  • Hazelwood, MO
National Provider Identifier
1447904941
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NIKODEM DENTAL HOLDINGS, INC.
Doing business as
Nikodem Dental Hazelwood
Practice address
811 Hazelwest Dr
Hazelwood, MO 63042-1749
Phone
(314) 731-7555
NPI assigned
Feb 4, 2022
Organization subpart
Yes
Parent organization
NIKODEM DENTAL HOLDINGS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Hannah Meeks
Title
Ar Specialist
Phone
(618) 977-6931

Specialties & licenses 1

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

Addresses

Primary practice location

811 Hazelwest Dr
Hazelwood, MO 63042-1749

Mailing address

6220 S Lindbergh Blvd Ste 101
Saint Louis, MO 63123-7839
Phone (314) 732-4591

Other names 1

  • Nikodem Dental Hazelwood Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nikodem Dental Holdings Inc9 organizations share this tax ID, including this one
Part of
Nikodem Dental Holdings Inc

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1447904941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 S LINDBERGH BLVD STE 101",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237839",
            "telephone_number": "314-732-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HAZELWEST DR",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630421749",
            "telephone_number": "314-731-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIKODEM DENTAL HOLDINGS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NIKODEM DENTAL HOLDINGS, INC.",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-04-01",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "MEEKS",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "AR SPECIALIST",
        "authorized_official_telephone_number": "618-977-6931"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nikodem Dental Hazelwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nikodem Dental Hazelwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazelwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.