Jack Douglas Laudenslager, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013828 Issued in MO

Practice address

303 Jungermann Rd
Suite B
Saint Peters, MO 63376-5366

Phone

(636) 498-1711

Fax

(636) 498-0436

NPI assigned

Jul 7, 2006

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467485318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 JUNGERMANN RD",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765366",
            "telephone_number": "636-498-1711",
            "fax_number": "636-498-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 JUNGERMANN RD",
            "address_2": "SUITE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633765366",
            "telephone_number": "636-498-1711",
            "fax_number": "636-498-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDENSLAGER",
        "first_name": "JACK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "013828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Alexandra Lasam
• Stephanie Lash, LPC
• Brittany Lasher
• Sarah Kaitlyn Laslo, MS., CCC-SLP
• Andrea D Latta, APRN,BC
• Nicole Laughlin, OTR/L
• Laura Wagner, Inc
• Christine Laurel
• Kaitlin Elizabeth Lavoi, M.S, CCC-SLP
• Sarah R Lavy, ANP

• General Practice Dentistry in Saint Peters, MO
• Providers in Saint Peters, 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 8, 2007; 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.