Midwest Dental Sleep Medicine Institute,LLC

Primary specialty

DentistTaxonomy code 122300000X

License

015476 Issued in MO

Legal business name

MIDWEST DENTAL SLEEP MEDICINE INSTITUTE,LLC

Practice address

12266 De Paul Dr
Suite 325
Bridgeton, MO 63044-2514

Phone

(314) 291-9000

Fax

(314) 291-0590

NPI assigned

Aug 7, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Michael Gotsis, DDSNPI 1871696203

Title

President/Owner

Phone

(314) 291-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

Practitioners 2

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

• Thomas Michael Gotsis, DDS

  • General Practice Dentistry
  • Bridgeton, MO
  • NPI 1871696203
  Medicare reassignment NPD Authorized official
• Kevin Dolan Burgdorf, D.D.S.

  • Student in an Organized Health Care Education/Training Program
  • Cincinnati, OH
  • NPI 1457514788
  NPD (past)

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1528477114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12266 DE PAUL DR",
            "address_2": "SUITE 325",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-9000",
            "fax_number": "314-291-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12266 DE PAUL DR",
            "address_2": "SUITE 325",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442514",
            "telephone_number": "314-291-9000",
            "fax_number": "314-291-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DENTAL SLEEP MEDICINE INSTITUTE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "GOTSIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "314-291-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "015476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MH Consumer Directed Services LLC
• Michael B. Dietrich, D.M.D.,P.C.
• Michael G Vranich DO PC
• Michael T Katsev DDS PC
• Shatanna M. Michael
• Midwest Emergency Associates de Paul LLC
• Midwest Housing Services LLC (Midwest Home Health, Inc.)
• Midwest Rehab Hospitalist, LLC
• Midwest Rehab Services LLC
• Peter Christian Mikolajczak, M.D.

• Dentist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.