Brent L Kincaid, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

015917 Issued in MO

Practice address

222 S Woods Mill Rd Ste 720N
Chesterfield, MO 63017-3650

Phone

(314) 434-0493

Fax

(314) 434-7883

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 27, 2022 through Dec 27, 2026

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1831155076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 720N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173650",
            "telephone_number": "314-434-0493",
            "fax_number": "314-434-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 720N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173650",
            "telephone_number": "314-434-0493",
            "fax_number": "314-434-7883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6 Jungermann Cir Ste 202",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761625",
            "country_code": "US",
            "telephone_number": "636-927-1222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11810 Gravois Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631271829",
            "country_code": "US",
            "telephone_number": "314-842-5340",
            "fax_number": "314-849-9567",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINCAID",
        "first_name": "BRENT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "015917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sung Ho Kim, D.D.S.
• Thomas Kim, MD
• Wonmin Kim
• Dorothy Kime, LPC
• Jordan Kimler
• Issurah N King
• L Lupe I King
• Kints LLC
• Sarah Kirchoff, SLP
• Meredith Kirn, PHARM.D

• Oral & Maxillofacial Surgery (D.M.D.) in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.