David M Ivey, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12332 Issued in MO

Practice address

11710 Old Ballas Rd Ste 205
Saint Louis, MO 63141-7076

Phone

(314) 866-6725

Fax

(314) 998-6725

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 1, 2014 through Feb 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ivey DDS and Rosenthal DMD PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Wentzville, MO
  • NPI 1861618811
  NPD Authorized official
• Oral Facial Surgery Institute of Illinois P C

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Belleville, IL
  • NPI 1740697333
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1851472856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231408",
            "telephone_number": "618-400-6725",
            "fax_number": "618-500-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD STE 205",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-866-6725",
            "fax_number": "314-998-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEY",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "012332",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "12332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whittney Renae Iver, FNP
• Jennifer J Iverson, ED.S., LPC, RPT
• Kimberly Susan Iverson, MT-BC
• Virginia A Ives, LCSW, MSW,ACSW MAED,
• Marsha J Ivester
• Samuel James Ivey, PHARM.D.
• Danielle Buchanan Ivie, DPT
• Eriuhn Ivory
• Krystal Ivory
• Alphonso Ivy Jr., PLPC

• Oral and Maxillofacial Surgery (Dentist) in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.