Angelina Anisimova, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2003013493 Issued in MO

Practice address

589 Mid Rivers Mall Dr
Saint Peters, MO 63376-2152

Phone

(636) 970-1595

Fax

(636) 279-1117

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Missouri Dental Professionals, Richard Straus, DMD, PC

  • General Practice Dentistry
  • Saint Peters, MO
  • NPI 1780804088
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831238096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762152",
            "telephone_number": "636-970-1595",
            "fax_number": "636-279-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 MID RIVERS MALL DR",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633762152",
            "telephone_number": "636-970-1595",
            "fax_number": "636-279-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANISIMOVA",
        "first_name": "ANGELINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2003013493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "408833614",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yalonda Amerson, FNP
• Erika Renee Anderson, P.A.
• Frank Kim Anderson, M.D.
• Emily Andrews
• Angels on Call Homecare LLC
• Sara Nicole Ankarstad, DPT
• Ryan Ansari, MD
• Michele F. Anthony, MSW, LCSW
• Diane Rene Appal, LPC
• Laura Appelbaum, PHARMD

• Dentist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.