Active NPI
Thomas Paul Fitzgerald
- Dentist
- Saint Louis, MO
National Provider Identifier
1861793366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2009011727
- Practice address
- 7458 Washington Ave
Saint Louis, MO 63130-4048 - Phone
- (720) 891-5115
- NPI assigned
- Nov 15, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2009011727 | MO | Primary |
Addresses
Primary practice location
7458 Washington Ave
Saint Louis, MO 63130-4048
Mailing address
7458 Washington Ave
Saint Louis, MO 63130-4048
Phone (720) 891-5115
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009011727 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289779200000",
"number": "1861793366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7458 WASHINGTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304048",
"telephone_number": "720-891-5115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7458 WASHINGTON AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631304048",
"telephone_number": "720-891-5115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "THOMAS",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-15",
"last_updated": "2010-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2009011727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- John Thomas Fitzgerald, CRNA
- Kelsey Marie Fitzgerald, CRNA
- Megan M Fitzgerald, MSW, PLCSW
- Michael David Fitzgerald, RPH
- Regina Fitzgerald
- Wilson Fitzgerald
- Fitzgibbons Psychological West County Psychological Associates
- Haley Danielle Fitzgibbons, MSW, LCSW
- Mary Fitzgibbons, PH.D
- Sean C Fitzmaurice, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.