Individual provider Active NPI

Jill Mari Kazmer

  • Dental Hygienist
  • Saint Louis, MO
National Provider Identifier
1811354541
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
020002740 Issued in IL
Practice address
12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346
Phone
(800) 325-3982
Fax
(877) 685-9880
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 020002740 IL Primary

Addresses

Primary practice location

12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346

Mailing address

12647 Olive Blvd Ste 600
Saint Louis, MO 63141-6346
Phone (800) 325-3982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020002740ILMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1811354541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12647 OLIVE BLVD STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416346",
            "telephone_number": "800-325-3982",
            "fax_number": "877-685-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12647 OLIVE BLVD STE 600",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416346",
            "telephone_number": "800-325-3982",
            "fax_number": "877-685-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZMER",
        "first_name": "JILL",
        "middle_name": "MARI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020002740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.