Edgerley Dental LLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Legal business name

EDGERLEY DENTAL LLC

Doing business as

Chesterfield Woodlake Dental and Prosthodontics

Practice address

14377 Woodlake Dr Ste 206
Chesterfield, MO 63017-5735

Phone

(314) 878-8880

Fax

(314) 658-9940

NPI assigned

Feb 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Paul Douglas Edgerley, DDS, MDSNPI 1588072391

Title

Prosthodontist/Dentist

Phone

(314) 878-8880

Specialties & licenses 2

Addresses

Other names 1

• Chesterfield Woodlake Dental and Prosthodontics Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Douglas Edgerley, D.D.S., MDS

  • Prosthodontics
  • Chesterfield, MO
  • NPI 1588072391

  Dentist

  NPD Authorized official

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1598357923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR STE 206",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-878-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14377 WOODLAKE DR STE 206",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175735",
            "telephone_number": "314-878-8880",
            "fax_number": "314-658-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGERLEY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "EDGERLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PROSTHODONTIST/DENTIST",
        "authorized_official_telephone_number": "314-878-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesterfield Woodlake Dental and Prosthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shae Dwyer, DC
• Ear Nose Throat Medical Service
• Earl R. Larson, D.D.S., P.C. (Wildhorse Dental)
• John Easterling, MAC
• Russell Hugh Eaves, PT
• Paul Douglas Edgerley, D.D.S., MDS
• Kristin Leslie Edmonds, MM MA CCC-SLP
• Laura Ann Edmundson, MPT
• Charles H. Edwards, PHYSICAL THERAPIST
• Emily Edwards, BCBA

• Prosthodontics in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Prosthodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.