Individual provider Active NPI

Matthew Kane Birke, D.D.S.

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1851592356
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2007014193 Issued in MO
Practice address
605 Old Ballas Rd
Suite 118
Saint Louis, MO 63141-7000
Phone
(314) 993-5310
NPI assigned
May 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2007014193 MO Primary

Addresses

Primary practice location

605 Old Ballas Rd
Suite 118
Saint Louis, MO 63141-7000

Mailing address

176 Sweetbriar LN
Kirkwood, MO 63122-5132
Phone (314) 435-7962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113000316 MO Order and Referring Only - DentistPractitioner - Dentist 4587966288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007014193MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. General Practice PastSince Mar 13, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851592356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 SWEETBRIAR LN",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631225132",
            "telephone_number": "314-435-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 OLD BALLAS RD",
            "address_2": "SUITE 118",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417000",
            "telephone_number": "314-993-5310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKE",
        "first_name": "MATTHEW",
        "middle_name": "KANE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2007014193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.