Active NPI
Pamela Trisha Yu, DDS
- Dentist
- Arnold, MO
National Provider Identifier
1881828648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2009013251
- Practice address
- 1708 Missouri State Rd
Arnold, MO 63010-2006 - Phone
- (636) 287-9331
- NPI assigned
- May 8, 2009
- Sex
- Female
- 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 | 2009013251 | MO | Primary |
Addresses
Primary practice location
1708 Missouri State Rd
Arnold, MO 63010-2006
Mailing address
178 Greenbriar Estates Dr
Saint Louis, MO 63122-3345
Phone (314) 966-0928
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 |
|---|---|---|---|
| 2009013251 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas John Kennedy of Missouri, DDS, P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Arnold, MO
- NPI 1992987036
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1881828648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 GREENBRIAR ESTATES DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631223345",
"telephone_number": "314-966-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1708 MISSOURI STATE RD",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630102006",
"telephone_number": "636-287-9331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU",
"first_name": "PAMELA",
"middle_name": "TRISHA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-08",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2009013251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.