Doherty Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DOHERTY FAMILY DENTAL, LLC

Practice address

8824 Litzsinger Rd
Brentwood, MO 63144-2222

Phone

(314) 961-3221

Fax

(314) 961-7477

NPI assigned

Dec 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Thomas Doherty, D.D.S.NPI 1598258501

Title

Owner

Phone

(314) 596-8974

Specialties & licenses 1

Addresses

Other names 1

• Brentwood Family Dentistry Doing business as

Practitioners 1

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

• Daniel Thomas Doherty

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1598258501
  NPD Authorized official

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1730776345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8824 LITZSINGER RD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442222",
            "telephone_number": "314-961-3221",
            "fax_number": "314-961-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8824 LITZSINGER RD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442222",
            "telephone_number": "314-961-3221",
            "fax_number": "314-961-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOHERTY FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-596-8974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sabin Dang, MD
• Katie Davis
• Katie Marlene Davis, PHARMD
• Taylor Marie Dettmann, DPT, PT
• Sarah E Diederich, DMD
• Micahel Joseph Doherty, DDS
• Amy Donovan
• Dream Acupuncture LLC
• Brittney Dreier
• Alia Durrani, MD

• General Practice Dentistry in Brentwood, MO
• Providers in Brentwood, 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 Dec 29, 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.