NPIMap

Organization Active NPI

Terry M. Trezek

  • General Practice Dentistry
  • O'Fallon, MO
National Provider Identifier
1881041713
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2000161566 Issued in MO
Legal business name
TERRY M. TREZEK
Practice address
1630 Market Center Dr
Suite 101
O Fallon, MO 63368-8407
Phone
(636) 329-1254
Fax
(636) 329-1837
NPI assigned
May 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Dr. Terry Michael Trezek, DMDNPI 1508880162
Title
Owner
Phone
(636) 329-1254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 2000161566 MO Primary

Addresses

Primary practice location

1630 Market Center Dr
Suite 101
O Fallon, MO 63368-8407

Mailing address

1630 Market Center Dr
Suite 101
O Fallon, MO 63368-8407
Phone (636) 329-1254

Other names 1

  • Terry M. Trezek, DMD, LLC Other name

National Provider Directory

National Provider Directory

Locations

1630 Market Center Blvd
Ste 101
O Fallon, MO 63368
Phone (636) 329-1254

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1881041713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 MARKET CENTER DR",
            "address_2": "SUITE 101",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688407",
            "telephone_number": "636-329-1254",
            "fax_number": "636-329-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 MARKET CENTER DR",
            "address_2": "SUITE 101",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633688407",
            "telephone_number": "636-329-1254",
            "fax_number": "636-329-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY M. TREZEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "TREZEK",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-329-1254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2000161566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Terry M. Trezek, DMD, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.