Scott F Nolen, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

015060 Issued in MO

Practice address

165 N. Meramec Ave
Suite 300
Clayton, MO 63105-3772

Phone

(314) 726-2755

Fax

(314) 726-9538

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 1, 2010 through Sep 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Gateway Oral and Maxillofacial Surgeons of St Louis, P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Clayton, MO
  • NPI 1184892028
  NPD

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1659443919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 N. MERAMEC AVE",
            "address_2": "SUITE 300",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053772",
            "telephone_number": "314-726-2755",
            "fax_number": "314-726-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 N. MERAMEC AVE",
            "address_2": "SUITE 300",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053772",
            "telephone_number": "314-726-2755",
            "fax_number": "314-726-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "SCOTT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019022030",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "015060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4235780",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "134798",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "15008",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2240308001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Clayton, MO
• Providers in Clayton, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.