Active NPI
Michael E Czeschin, DMD
- Dentist
- Saint Louis, MO
National Provider Identifier
1710548557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2016021700
- Practice address
- 1501 Hampton Ave
Saint Louis, MO 63139-3038 - Phone
- (314) 647-2828
- Fax
- (146) 472-7933
- NPI assigned
- Jun 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2016021700 | MO | Primary |
Addresses
Primary practice location
1501 Hampton Ave
Saint Louis, MO 63139-3038
Mailing address
1501 Hampton Ave
Saint Louis, MO 63139-3038
Phone (314) 647-2828
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2016021700 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561334400000",
"number": "1710548557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 HAMPTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631393038",
"telephone_number": "314-647-2828",
"fax_number": "146-472-7933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 HAMPTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631393038",
"telephone_number": "314-647-2828",
"fax_number": "146-472-7933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CZESCHIN",
"first_name": "MICHAEL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-24",
"last_updated": "2019-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2016021700",
"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 Jun 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.