Individual provider Active NPI

Justin M Firth, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Louis, MO
National Provider Identifier
1689455008
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2021020354 Issued in MO
Practice address
3890 S Lindbergh
#115
St Louis, MO 63127
Phone
(314) 843-5553
Fax
(314) 487-1146
NPI assigned
Oct 11, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2021020354 MO Primary

Addresses

Primary practice location

3890 S Lindbergh
#115
St Louis, MO 63127

Mailing address

5524 Telegraph Road
Unit 101
St Louis, MO 63129
Phone (314) 487-1141

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

State licenses

LicenseStateTypeSpecialty
2021020354MOMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
George D Bankhead DDS Ms PC Orthodontics and Dentofacial Orthopedics PastSince Oct 15, 2023 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1689455008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5524 TELEGRAPH ROAD",
            "address_2": "UNIT 101",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63129",
            "telephone_number": "314-487-1141",
            "fax_number": "314-487-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 S LINDBERGH",
            "address_2": "#115",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63127",
            "telephone_number": "314-843-5553",
            "fax_number": "314-487-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIRTH",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2021020354",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 17, 2023; 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.