Active NPI
Dante Joseph Iannazzo, D.C.
- Chiropractor
- Brentwood, MO
National Provider Identifier
1598839797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2005029195
- Practice address
- 8079 Manchester Rd
Brentwood, MO 63144-2817 - Phone
- (314) 647-3847
- Fax
- (314) 644-0449
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2005029195 | MO | Primary |
Addresses
Primary practice location
8079 Manchester Rd
Brentwood, MO 63144-2817
Mailing address
8079 Manchester Rd
Brentwood, MO 63144-2817
Phone (314) 647-3847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005029195 | MO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brentwood Family Chiropractic Center, LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Saint Louis, MO
- NPI 1225257462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598839797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8079 MANCHESTER RD",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631442817",
"telephone_number": "314-647-3847",
"fax_number": "314-644-0449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8079 MANCHESTER RD",
"city": "BRENTWOOD",
"state": "MO",
"postal_code": "631442817",
"telephone_number": "314-647-3847",
"fax_number": "314-644-0449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNAZZO",
"first_name": "DANTE",
"middle_name": "JOSEPH",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2005029195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.