Active NPI
Donald Vincent Huebener, DDS, MS
- Pediatric Dentistry
- Saint Louis, MO
National Provider Identifier
1669654737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 11144
- Practice address
- 1 Childrens PL
LS-2
Saint Louis, MO 63110-1002 - Phone
- (314) 454-6250
- NPI assigned
- Nov 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 11144 | MO | Primary |
Addresses
Primary practice location
1 Childrens PL
LS-2
Saint Louis, MO 63110-1002
Mailing address
1 Childrens PL
LS-2
Saint Louis, MO 63110-1002
Phone (314) 454-6250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 263301 | Other | MO | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11144 | MO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Louis Children'S Hospital | Past | Accepting new patients |
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Saint Louis, MO
- NPI 1447302161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1669654737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "LS-2",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS PL",
"address_2": "LS-2",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101002",
"telephone_number": "314-454-6250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUEBENER",
"first_name": "DONALD",
"middle_name": "VINCENT",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-30",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MO",
"license": "11144",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "263301",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.