Kenneth B Scroggins, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2011021923 Issued in MO

Practice address

11780 Manchester Rd
Suite 105
Saint Louis, MO 63131-4600

Phone

(314) 965-3500

Fax

(314) 965-7721

NPI assigned

Aug 29, 2011

Sex

Male

Sole proprietor

No

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kenneth B. Scroggins, D.M.D., LLC

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1639567811
  NPD (past) Authorized official

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1538449061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11780 MANCHESTER RD",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314600",
            "telephone_number": "314-965-3500",
            "fax_number": "314-965-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11780 MANCHESTER RD",
            "address_2": "SUITE 105",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631314600",
            "telephone_number": "314-965-3500",
            "fax_number": "314-965-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCROGGINS",
        "first_name": "KENNETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2011021923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyanna Scott
• Albert Scrimsher Jr., APRN
• Scriptcare Solutions, LLC (SCS Pharmacy)
• Evelyn Kay Scrivner, ACNP
• Madeline Scrivner, PT, DPT
• Stacey Scrogin, FNP
• Amber Scruton, R.N.
• Walter Robert Scull, M.ED., LPC
• Kristen Ann Scullin-Hartman, MD
• Thomas Scully, MD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, 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 Dec 23, 2014; 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.