David Guilbeault DMD Mid Rivers Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2000174030 Issued in MO

Legal business name

DAVID GUILBEAULT DMD MID RIVERS DENTAL GROUP

Doing business as

Mid Rivers Dental Group

Practice address

300 Mid Rivers Mall Dr
Saint Peters, MO 63376-1565

Phone

(636) 937-5883

NPI assigned

Mar 28, 2013

Organization subpart

No

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

Authorized official

Name

Dr. David Guilbeault, DMD

Title

Owner/Dentist

Phone

(618) 692-1110

Specialties & licenses 1

Addresses

Other names 1

• Mid Rivers Dental Group Doing business as

Locations

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1801139803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6117 TIMBERWOLFE DR",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761565",
            "telephone_number": "636-937-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID GUILBEAULT DMD MID RIVERS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-28",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "GUILBEAULT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "618-692-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2000174030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid Rivers Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Dannevik, MS, BCBA, LBA
• Ahmad Daraghmeh, MD
• Mia Daveta, APRN
• Rebecca Ann Davey, OTRL
• David a. Lipsitz, PH.D., Inc
• David M Ivey DDS PC
• Sasha Marie David
• Bradley A Davis, D.C.
• Christine Denise Davis, M.S.
• Jennifer Lueders Davis, FNP-C

• General Practice Dentistry in Saint Peters, MO
• Providers in Saint Peters, 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 Nov 5, 2014; 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.