NPIMap

Organization Active NPI

Michael J Pernoud DDS PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Washington, MO
National Provider Identifier
1659538973
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
MICHAEL J PERNOUD DDS PC
Practice address
1015 Washington SQ Ste F
Washington, MO 63090-5307
Phone
(636) 239-5959
NPI assigned
May 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Dr. Michael James Pernoud, DDSNPI 1962478305
Title
Pres/Sec
Phone
(636) 239-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

1015 Washington SQ Ste F
Washington, MO 63090-5307

Mailing address

1015 Washington SQ Ste F
Washington, MO 63090-5307
Phone (636) 239-5959

National Provider Directory

National Provider Directory

Locations

1015 Washington Sq
Ste F
Washington, MO 63090
Phone (636) 239-5959

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1659538973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ STE F",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ STE F",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J PERNOUD DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "PERNOUD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRES/SEC",
        "authorized_official_telephone_number": "16362395959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.