Ackeilia K Heatrice, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2020013343 Issued in MO

Practice address

24 Kiefer Creek Rd
Ellisville, MO 63021-6013

Phone

(314) 367-7848

NPI assigned

Jun 12, 2009

Last updated

Aug 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ackeilia.heatrice.p1@direct.phcenters.nextgenshare.com

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

• Betty Jean Kerr People's Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1194797787
  Medicare reassignment NPD
• Ackeilia Heatrice DDS PC

  dba Bloomy's Pediatric Dentistry

  • Pediatric Dentistry
  • Ellisville, MO
  • NPI 1972325306
  NPD Authorized official
• Bloomy's Laser Dentistry

  • Pediatric Dentistry
  • Ellisville, MO
  • NPI 1851214324
  NPD (past) Authorized official
• Betty Jean Kerr People's Health Centers

  • Community/Behavioral Health Agency
  • Saint Louis, MO
  • NPI 1679604318
  NPD
• Children's Dental Zone

  • Dental Clinic/Center
  • Florissant, MO
  • NPI 1700172806
  NPD (past)
• The W Dental Group

  • Dental Clinic/Center
  • Florissant, MO
  • NPI 1477840387
  NPD (past)

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1609003060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 KIEFER CREEK RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630216013",
            "telephone_number": "636-333-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 KIEFER CREEK RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630216013",
            "telephone_number": "314-367-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATRICE",
        "first_name": "ACKEILIA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "056027-1",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "2020013343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliot Haskins
• Madelynn Heady
• Healthy Family Home Care, LLC
• Hearing Health Care, Inc.
• Audrey Heath, FNP-C
• Kimberly Nicole Heifner, FNP
• Lauren Elizabeth Hendrix, D.C., M.S.
• Kimberly A Herren, COTA/L
• Michael Hicks
• Judy Hillyer, LCSW

• Pediatric Dentistry in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.