NPIMap

Organization Active NPI

Kirk D. Satrom, DDS Ms PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • O'Fallon, IL
National Provider Identifier
1669778601
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
060.009554 Issued in IL
Legal business name
KIRK D. SATROM, DDS MS PC
Practice address
741 W State St
Suite # 2
O Fallon, IL 62269-1971
Phone
(618) 624-0800
Fax
(618) 624-0053
NPI assigned
Feb 9, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Dr. Kirk D Satrom, DDS MSNPI 1386788768
Title
President
Phone
(618) 624-0800

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 060.009554 IL Primary

Addresses

Primary practice location

741 W State St
Suite # 2
O Fallon, IL 62269-1971

Mailing address

741 W State St
Suite # 2
O Fallon, IL 62269-1971
Phone (618) 624-0800

National Provider Directory

National Provider Directory

Locations

741 W State St
Ste 2
O Fallon, IL 62269
Phone (618) 624-0800

Practitioners & affiliated clinicians

Practitioners 2

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": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1669778601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 W STATE ST",
            "address_2": "SUITE # 2",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691971",
            "telephone_number": "618-624-0800",
            "fax_number": "618-624-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 W STATE ST",
            "address_2": "SUITE # 2",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691971",
            "telephone_number": "618-624-0800",
            "fax_number": "618-624-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRK D. SATROM, DDS MS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "SATROM",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-624-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "060.009554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.