Daniel Pernoud, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2012015446 Issued in MO

Practice address

12401 Olive Blvd Ste 200
Creve Coeur, MO 63141-5448

Phone

(314) 275-9009

NPI assigned

May 24, 2012

Last updated

Jun 25, 2013By 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 1, 2018 through Nov 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Daniel R. Pernoud, DDS, LLC

  dba Glo Dental Studio

  • Dental Clinic/Center
  • Creve Coeur, MO
  • NPI 1477447357
  NPD Authorized official

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1740540632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD STE 200",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "314-275-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD STE 200",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "314-275-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNOUD",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2012015446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lena Pearlman, LCSW
• Abby Cronin Peer, AGNP
• Pellegrine, Inc Dba Pearle Vision
• Robert Dean Pelley, LPC
• Amy L Pelligreen, CRNA
• Linda Susan Pevnick, MSW
• Melinda Louise Pfeiffer
• Pui-Yue Phan III
• Charles Phelan
• Serin Phruttitum, MD

• Dentist in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.