Individual provider Active NPI

Stuart D Waite, DDS, MBA

  • Dentist
  • St Louis, MO
National Provider Identifier
1740379320
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
014970 Issued in MO
Practice address
621 S New Ballas Rd
Ste 10a
St Louis, MO 63141-8232
Phone
(314) 251-5775
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 014970 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Ste 10a
St Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Ste 10a
St Louis, MO 63141-8232
Phone (314) 251-5775

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130118000292 MO Practitioner - Oral Surgery 4587817796 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
014970MOMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic East Communities CurrentSince Feb 1, 2018 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 25, 2012 Accepting new patients
Mercy Hospitals East Communities CurrentSince Sep 25, 2012 Accepting new patients
Stuart D. Waite DDS PC General Practice PastSince Aug 23, 2005 Accepting new patients

Locations

621 S New Ballas Rd
Ste 10A
Saint Louis, MO 63141
Phone (314) 251-5775

621 S New Ballas Rd
Ste 4017B
Saint Louis, MO 63141
Phone (314) 872-9192

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1740379320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "STE 10A",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "STE 10A",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "STUART",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "014970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis, MO

Sources for this page

Verify at the official NPI Registry.