Michael Q Edwards DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

DE015747 Issued in MO

Legal business name

MICHAEL Q EDWARDS DMD PC

Practice address

124 West Main Street
Union, MO 63084

Phone

(636) 583-2612

Fax

(636) 583-6479

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Q Edwards, DMDNPI 1396968426

Title

Owner Ceo

Phone

(636) 583-2612

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Optima Dental Group Doing business as

Locations

Practitioners 1

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

• Michael Q. Edwards, D.M.D.

  • General Practice Dentistry
  • Union, MO
  • NPI 1396968426
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558445221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 WEST MAIN STREET",
            "city": "UNION",
            "state": "MO",
            "postal_code": "63084",
            "telephone_number": "636-583-2612",
            "fax_number": "636-583-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 WEST MAIN STREET",
            "city": "UNION",
            "state": "MO",
            "postal_code": "63084",
            "telephone_number": "636-583-2612",
            "fax_number": "636-583-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL Q EDWARDS DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "636-583-2612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": "DE015747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PLAN",
            "identifier": "2015747",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optima Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Harika Rao Mendu, DMD
• Menm, LLC
• Meramec Recovery Center, Inc
• Meramec Recovery Center, Inc.
• Patrick Meuth, DC
• Missouri Alcohol Assessment Consultants, Inc.
• Cynthia Ann Modrosic, MA, MS
• Jorie Renee Moeller, LCSW
• Deborah R Monzyk, MSN, RN, BC, FNP-C
• Rochelle Marie Morgan, LPC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.