Individual provider Active NPI

Tiffany Krimminger, DMD

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1699205062
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2017019881 Issued in MO
Practice address
621 S New Ballas Rd Ste 10a
Saint Louis, MO 63141-8239
Phone
(314) 251-5775
Fax
(314) 251-5776
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2017019881 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 10a
Saint Louis, MO 63141-8239

Mailing address

621 S New Ballas Rd Ste 10a
Saint Louis, MO 63141-8239
Phone (314) 251-5775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808000970 MO Practitioner - Dentist 3072840404 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017019881MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Jul 1, 2019 Accepting new patients
Stuart D. Waite DDS PC General Practice PastSince Feb 23, 2025 Accepting new patients

Locations

621 S New Ballas Rd
Ste 10A
Saint Louis, MO 63141
Phone (314) 251-5775

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1699205062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 10A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418239",
            "telephone_number": "314-251-5775",
            "fax_number": "314-251-5776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 10A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418239",
            "telephone_number": "314-251-5775",
            "fax_number": "314-251-5776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIMMINGER",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2017019881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.