Individual provider Active NPI

Dez Ziegenhorn, DDS

  • Dentist
  • Saint Peters, MO
National Provider Identifier
1487793881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2005015582 Issued in MO
Practice address
65 Centre PT
Suite 200
Saint Peters, MO 63304-8519
Phone
(636) 928-0144
Fax
(636) 447-6605
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2005015582 MO Primary

Addresses

Primary practice location

65 Centre PT
Suite 200
Saint Peters, MO 63304-8519

Mailing address

65 Centre PT
Suite 200
Saint Peters, MO 63304-8519
Phone (636) 928-0144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150522000762 MO Order and Referring Only - DentistPractitioner - Dentist 6002136637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487793881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 CENTRE PT",
            "address_2": "SUITE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633048519",
            "telephone_number": "636-928-0144",
            "fax_number": "636-447-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CENTRE PT",
            "address_2": "SUITE 200",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633048519",
            "telephone_number": "636-928-0144",
            "fax_number": "636-447-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEGENHORN",
        "first_name": "DEZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2005015582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.