NPIMap

Organization Active NPI

Lester C Joern, Jr, DDS, PC

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1720075005
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12510 Issued in MO
Legal business name
LESTER C JOERN, JR, DDS, PC
Practice address
6451 Chippewa St
Suite a
Saint Louis, MO 63109-2104
Phone
(314) 752-7468
Fax
(314) 752-5168
NPI assigned
Oct 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lester C Joern Jr., DDSNPI 1154404879
Title
President
Phone
(314) 752-7468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 12510 MO Primary

Addresses

Primary practice location

6451 Chippewa St
Suite a
Saint Louis, MO 63109-2104

Mailing address

6451 Chippewa St
Suite a
Saint Louis, MO 63109-2104
Phone (314) 752-7468

Other identifiers 6

IdentifierTypeStateIssuer
V12510OtherMOBCBS - TEXAS
15138OtherMOBCBS - MO
519832OtherMOWITH UNITED CONCORDIA
014487OtherMOAETNA DMO
103333OtherMOCIGNA DHMO
CBAR1OtherMOBCBS - ARKANSAS

Other names 1

  • South St. Louis Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

6451 Chippewa St
#A
Saint Louis, MO 63109
Phone (314) 752-7468

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720075005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "address_2": "SUITE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-752-7468",
            "fax_number": "314-752-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 CHIPPEWA ST",
            "address_2": "SUITE A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092104",
            "telephone_number": "314-752-7468",
            "fax_number": "314-752-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESTER C JOERN, JR, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOERN",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-752-7468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "12510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - TEXAS",
            "identifier": "V12510",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MO",
            "identifier": "15138",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WITH UNITED CONCORDIA",
            "identifier": "519832",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA DMO",
            "identifier": "014487",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DHMO",
            "identifier": "103333",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - ARKANSAS",
            "identifier": "CBAR1",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South St. Louis Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.