Stephen Gerard Nikodem, DDS,.MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE-015579 Issued in MO

Practice address

4116 Von Talge Rd Ste a
Saint Louis, MO 63128-1957

Phone

(314) 894-1311

Fax

(314) 894-0710

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Stephen G. Nikodem DDS Ms PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Saint Louis, MO
  • NPI 1275656480
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700909991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 VON TALGE RD STE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281957",
            "telephone_number": "314-894-1311",
            "fax_number": "314-894-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 VON TALGE RD STE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281957",
            "telephone_number": "314-894-1311",
            "fax_number": "314-894-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKODEM",
        "first_name": "STEPHEN",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "DDS,.MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "DE-015579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikodem Dental Holdings, Inc.
• Nikodem Dental Holdings, Inc.
• Keith Andrew Nikodem, DDS
• Luke Andrew Nikodem, DDS
• Raymond Gerard Nikodem, DDS
• Stephen Mark Nikodem, DDS
• Jamie Louise Nilson, RD
• Pascal Nilsson, MD
• Praveen Srisatya Nimmagadda, MD
• Shalaka Nimmagadda, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.