Individual provider Active NPI

Olumayowa Stella Amu, DDS

  • General Practice Dentistry
  • Festus, MO
National Provider Identifier
1629778576
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2025038699 Issued in MO
Practice address
1275 N Truman Blvd
Festus, MO 63028-1176
Phone
(844) 853-8937
NPI assigned
Mar 8, 2023
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2025038699 MO Primary

Addresses

Primary practice location

1275 N Truman Blvd
Festus, MO 63028-1176

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250922003418 MO Practitioner - Dentist 6800391814 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
The Dental School at University of Texas HSC at San Antonio, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1800 Community
Clinton, MO 64735-8804

6611 Hayman Dr
Katy, TX 77449-7719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025038699MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Sep 15, 2025 Accepting new patients
Compass Health, Inc CurrentSince Sep 15, 2025 Accepting new patients

Locations

1845 Jeffco Blvd
Arnold, MO 63010

849 Jeffco Blvd
Arnold, MO 63010
Phone (636) 282-5184

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

1275 N Truman Blvd
Festus, MO 63028
Phone (636) 937-4686

4 Hickory Ridge Rd
Ste 600
Hillsboro, MO 63050
Phone (636) 481-6040

4300 Gravois Rd
House Springs, MO 63051
Phone (636) 321-0150

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1629778576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N TRUMAN BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281176",
            "telephone_number": "844-853-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMU",
        "first_name": "OLUMAYOWA",
        "middle_name": "STELLA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2025038699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

Verify at the official NPI Registry.