Paul J. Dooley, D.D.S.
Individual provider Active NPI Dentist · Warrenton, MO
NPI 1679628937 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679628937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 13462 (MO)
- Practice address
- 708 Steinhagen Rd
Warrenton, MO 63383-1115 - Phone
- (636) 456-3362
- Fax
- (636) 456-3362
- NPI assigned
- Jan 24, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150512001439 | MO | Order and Referring Only - Oral Surgery |
4284953332 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13462 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paul J Dooley DDS PC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13462 | MO | Yes |
Addresses
Primary practice location
708 Steinhagen Rd
Warrenton, MO 63383-1115
Mailing address
708 Steinhagen Rd
Warrenton, MO 63383-1115
Phone (636) 456-3362
Other providers in Warrenton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.