NPIMap

Organization Active NPI

Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • Bridgeton, MO
National Provider Identifier
1649693144
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC
Practice address
12758 Boenker LN
Bridgeton, MO 63044-2436
Phone
(314) 739-3300
Fax
(314) 739-0005
NPI assigned
Feb 4, 2014
Organization subpart
Yes
Parent organization
MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Authorized official

Name
Kendra Walker
Title
Credentialing Team Lead
Phone
(217) 540-8513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

12758 Boenker LN
Bridgeton, MO 63044-2436

Mailing address

12758 Boenker Lane
Bridgeton, MO 63044
Phone (314) 739-3300

Other names 1

  • Total Care Dental-Bridgeton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC60 organizations share this tax ID, including this one
Part of
Heartland Family Dental Care of Missouri - Richard E Workman DMD PC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

12758 Boenker Ln
Bridgeton, MO 63044
Phone (314) 739-3300

NPI Registry JSON

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1649693144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12758 BOENKER LANE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044",
            "telephone_number": "314-739-3300",
            "fax_number": "314-739-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12758 BOENKER LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442436",
            "telephone_number": "314-739-3300",
            "fax_number": "314-739-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSOURI DENTAL PROFESSIONALS, RICHARD STRAUS, DMD, PC",
        "enumeration_date": "2014-02-04",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING TEAM LEAD",
        "authorized_official_telephone_number": "217-540-8513"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Care Dental-Bridgeton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Total Care Dental-Bridgeton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2018; 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.