John R Landgraf, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

012991 Issued in MO

Practice address

504 N New Florissant Rd
Florissant, MO 63031-4802

Phone

(314) 831-8500

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• STL Mid County Dental LLC

  • Dental Clinic/Center
  • Florissant, MO
  • NPI 1417876319
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780739375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N NEW FLORISSANT RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314802",
            "telephone_number": "314-831-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N NEW FLORISSANT RD",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630314802",
            "telephone_number": "314-831-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDGRAF",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "012991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanja Lacy
• Ladelle Investment Co., Inc.
• Sopan Lahewala, M.D.
• Racheal Lakine-Harden, FNP
• Gilbert Lakine II
• Sean Landgraf
• Emily Lasek
• Lasting Impressions Home Remodel Center, LTD.
• Latter Glory Home Care, Inc.
• Ashley Laura

• General Practice Dentistry in Florissant, MO
• Providers in Florissant, 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 8, 2007; 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.