Pedaitric Dental and Orthodontic Associates of St Louis

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14227 Issued in MO

Legal business name

PEDAITRIC DENTAL AND ORTHODONTIC ASSOCIATES OF ST LOUIS

Practice address

430 S Clay Ave
Kirkwood, MO 63122-5808

Phone

(314) 965-7630

NPI assigned

Jan 19, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Veraldi, D.M.D.

Title

Owner

Phone

(314) 965-7630

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1780989061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S CLAY AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225808",
            "telephone_number": "314-965-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S CLAY AVE",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225808",
            "telephone_number": "314-965-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDAITRIC DENTAL AND ORTHODONTIC ASSOCIATES OF ST LOUIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-19",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "VERALDI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-965-7630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "14227",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "14227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathway Home Care, LLC
• Sarah Marie Patterson-Mills, MA/LPC
• Megan Patterson, M. ED, NCC, PLPC
• Charles William Pearson
• William Edward Pearson, M.D.
• Amanda Peiffer, D.C.
• Caroline Penberthy, M.S.W., L.C.S.W.
• Maxine Jeanette Pence, LD, RD
• Mallory A. Perry, M.A., L.P.C.
• Rachel A Peterka

• Pediatric Dentistry in Kirkwood, MO
• Providers in Kirkwood, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.