Padmini R Muddasani, DDS, MS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · O'Fallon, MO

NPI 1659486249 · NPPES record last updated Nov 10, 2009

Key facts

NPI
1659486249
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
DE015883 (MO)
Practice address
2410 Hwy K
O'Fallon, MO 63368
Phone
(636) 978-8381
Fax
(636) 272-2377
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE015883MOMDOrthodontics and Dentofacial Orthopedic Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DE015883 MO Yes

Addresses

Primary practice location

2410 Hwy K
O'Fallon, MO 63368

Mailing address

2410 Hwy K
O'Fallon, MO 63368
Phone (636) 978-8381

Other providers in O'Fallon, MO

All providers in O'Fallon, MO · Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

Sources for this page

Verify at the official NPI Registry.