NPIMap

Organization Active NPI

Michael W. Noble, DMD, PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Kirkwood, MO
National Provider Identifier
1457505604
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
010781 Issued in MO
Legal business name
MICHAEL W. NOBLE, DMD, PC
Practice address
12166 Old Big Bend Rd
Ste. 101
Kirkwood, MO 63122-6844
Phone
(314) 822-7123
Fax
(314) 822-7814
NPI assigned
Nov 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Authorized official

Name
Mr. Scott E Graham
Title
Office Manager
Phone
(314) 251-6725

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 010781 MO Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X 011430 MO

Addresses

Primary practice location

12166 Old Big Bend Rd
Ste. 101
Kirkwood, MO 63122-6844

Mailing address

12166 Old Big Bend Rd
Ste. 101
Kirkwood, MO 63122-6844
Phone (314) 822-7123

Other names 1

  • Oral Facial Surgery Institute Doing business as

National Provider Directory

National Provider Directory

Locations

12166 Old Big Bend Rd
Ste 101
Saint Louis, MO 63122
Phone (314) 822-6725

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275004800000",
    "number": "1457505604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD",
            "address_2": "STE. 101",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226844",
            "telephone_number": "314-822-7123",
            "fax_number": "314-822-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12166 OLD BIG BEND RD",
            "address_2": "STE. 101",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631226844",
            "telephone_number": "314-822-7123",
            "fax_number": "314-822-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL W. NOBLE, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-13",
        "last_updated": "2010-05-28",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "314-251-6725",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "010781",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "011430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oral Facial Surgery Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2010; 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.