Deshmukh DDS, PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

015495 Issued in MO

Legal business name

DESHMUKH DDS, PC

Doing business as

Periodontal Specialists , PC

Practice address

1034 S Brentwood Blvd
Suite #740
Saint Louis, MO 63117-1223

Phone

(314) 725-4221

Fax

(314) 725-4319

NPI assigned

May 4, 2007

Last updated

Aug 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Videsh Damodar Deshmukh, D.D.S.

Title

President

Phone

(314) 725-4221

Specialties & licenses 1

Addresses

Other names 1

• PERIODONTAL SPECIALISTS , PC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• D Douglas Miley, D.M.D.

  • Dentist
  • Alton, IL
  • NPI 1871756130

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409184000000",
    "number": "1720290372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD",
            "address_2": "SUITE #740",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171223",
            "telephone_number": "314-725-4221",
            "fax_number": "314-725-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD",
            "address_2": "SUITE #740",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171223",
            "telephone_number": "314-725-4221",
            "fax_number": "314-725-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESHMUKH DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2014-08-28",
        "status": "A",
        "authorized_official_last_name": "DESHMUKH",
        "authorized_official_first_name": "VIDESH",
        "authorized_official_middle_name": "DAMODAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-725-4221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "015495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PERIODONTAL SPECIALISTS , PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John D Descher, FNP
• Carl J Deselm, MD
• Katie Deselm
• Deshay Outreach Center
• Rashonda Deshay, MSW, LCSW
• Ameya Ashutosh Deshmukh
• Matthew Desiderio, CAA
• Erin Desmarais
• Jeffrey Edward Desmidt
• Heather Desmond, LPC

• Periodontics in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Periodontics in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.