Peter Pagano, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012313 Issued in MO

Practice address

12334 Olive Blvd
Saint Louis, MO 63141-6443

Phone

(314) 576-3000

Fax

(314) 576-3566

NPI assigned

Jul 21, 2008

Last updated

Jul 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1720243603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12334 OLIVE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416443",
            "telephone_number": "314-576-3000",
            "fax_number": "314-576-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12334 OLIVE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416443",
            "telephone_number": "314-576-3000",
            "fax_number": "314-576-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGANO",
        "first_name": "PETER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "012313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fiona Padrutt, DPT
• Alan Valente A Padua, M.D.
• Paean Physician Services LLC
• Sara Paek
• Joseph Pagano
• Salvatore J Pagano
• Page Belt,LLC (Midwest Express Home Care)
• Ebony Page-Phillips, MD
• Jennifer Lynn Page, M.D.
• Karen Page, MS, OTR/L

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.