Individual provider Active NPI

Brittany Daniel, DDS

  • General Practice Dentistry
  • Florissant, MO
National Provider Identifier
1861021354
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2020040861 Issued in MO
Practice address
11642 W Florissant Ave
Florissant, MO 63033-6723
Phone
(314) 838-8220
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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 2020040861 MO Primary

Addresses

Primary practice location

11642 W Florissant Ave
Florissant, MO 63033-6723

Mailing address

5153 Bristol Rock Rd
Black Jack, MO 63033-7579

Other practice location 1

959 Myrtle Ave
Eureka, CA 95501-1219
Phone (707) 441-7078

Other practice location 2

5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone (314) 367-7848

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020040861MOMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1861021354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5153 BRISTOL ROCK RD",
            "city": "BLACK JACK",
            "state": "MO",
            "postal_code": "630337579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11642 W FLORISSANT AVE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630336723",
            "telephone_number": "314-838-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "959 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955011219",
            "country_code": "US",
            "telephone_number": "707-441-7078",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5701 Delmar Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631122617",
            "country_code": "US",
            "telephone_number": "314-367-7848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "BRITTANY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2020040861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.