Theodore Anthony Rechtin III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2000157414 Issued in MO

Practice address

3450 Bridgeland Dr
Suite a
Bridgeton, MO 63044-2605

Phone

(314) 770-0400

Fax

(314) 770-0170

NPI assigned

Aug 18, 2006

Last updated

Nov 14, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• He & Ta Rechtin DDS,PC

  • General Practice Dentistry
  • Bridgeton, MO
  • NPI 1043324593
  NPD (past) Authorized official

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1871607994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 BRIDGELAND DR STE A",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442605",
            "telephone_number": "314-770-0400",
            "fax_number": "314-770-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 BRIDGELAND DR",
            "address_2": "SUITE A",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442605",
            "telephone_number": "314-770-0400",
            "fax_number": "314-770-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECHTIN",
        "first_name": "THEODORE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "2000157414",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2000157414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond F. Mohrman MD PC
• Imaad Razzaque, M.D.
• Naveed Razzaque, M.D.
• Sarah Elizabeth Rebello, DC
• Heather Elizabeth Rechtin, DDS
• Reddy MD LLC
• Timothy F Reed, MD
• Tyler Reed, DPM
• Molly Reents
• Zafar Rehmani, M.D.

• General Practice Dentistry in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.