Kevin Ferguson Postol, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE015391 Issued in MO

Practice address

1338 Big Bend Square Shop Ctr
Ballwin, MO 63021-7618

Phone

(636) 394-9587

Fax

(636) 394-9624

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sleep Disorder Dentistry LLC

  • Customized Equipment (DME)
  • Ballwin, MO
  • NPI 1396113080
  NPD Authorized official

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1881680684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 BIG BEND SQUARE SHOP CTR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217618",
            "telephone_number": "636-394-9587",
            "fax_number": "636-394-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 BIG BEND SQUARE SHOP CTR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630217618",
            "telephone_number": "636-394-9587",
            "fax_number": "636-394-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSTOL",
        "first_name": "KEVIN",
        "middle_name": "FERGUSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "DE015391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry M Pierson, PT
• Elizabeth Pitcher, OTR/L
• Plaza Orthodontics
• Nishant Poddar, MD
• Polished - Melissa a Smith DDS PC
• Preferred Hospice of Missouri Northeast LLC
• Premier Healthcare STL LLC
• Daniel Thomas Price, RPH
• Kelly Price, PT, DPT, ATC
• Primary Care Chiropractic LLC

• General Practice Dentistry in Ballwin, MO
• Providers in Ballwin, 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 Feb 17, 2024; 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.