Dr. Gregory J. Pernoud, D.D.S., P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

012735 Issued in MO

Legal business name

DR. GREGORY J. PERNOUD, D.D.S., P.C.

Practice address

112 South Second Street
Festus, MO 63028

Phone

(636) 937-1515

Fax

(636) 937-0790

NPI assigned

Oct 12, 2006

Last updated

Jul 29, 2013By 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. Gregory J. Pernoud, D.D.S.NPI 1265868863

Title

President

Phone

(636) 937-1515

Specialties & licenses 1

Addresses

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.

• Gregory Pernoud, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Rolla, MO
  • NPI 1265868863
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1780773242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 E HWY 72",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "65401",
            "telephone_number": "573-364-1934",
            "fax_number": "573-364-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SOUTH SECOND STREET",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "63028",
            "telephone_number": "636-937-1515",
            "fax_number": "636-937-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GREGORY J. PERNOUD, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "PERNOUD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-937-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "012735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Patricia Donovan, RNCPNP
• Rajen H Doshi, MD
• Kelly Jill Dougherty, MD
• Marzena R Dowd, MSW, LCSW
• Zachary W Dowdy, DPT
• Dr. Louis J. Ortmann Dental Group Inc
• Dr. Michael Yankowitz LLC
• Dr. Micheal Yankowitz LLC
• Draves Family Practice
• Donna Marie Draves, P.T.

• Oral and Maxillofacial Surgery (Dentist) in Festus, MO
• Providers in Festus, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.