James William Maxwell Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

202029903 Issued in MO

Practice address

10000 Watson Road, South Building, Suite J
Saint Louis, MO 63126-1854

Phone

(314) 463-5655

Fax

(314) 821-0381

NPI assigned

Dec 18, 2009

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

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.

• Crestwood Dental Group Maxwell DMD PC

  • Dentist
  • St Louis, MO
  • NPI 1184721268
  NPD (past) Authorized official

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1891024956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 WATSON ROAD",
            "address_2": "SOUTH BUILDING SUITE J",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63126",
            "telephone_number": "314-463-5655",
            "fax_number": "314-821-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 WATSON ROAD, SOUTH BUILDING, SUITE J",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261854",
            "telephone_number": "314-463-5655",
            "fax_number": "314-821-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-18",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "202029903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxim Healthcare Services, Inc.
• Sara Gina Maximus, PMHNP
• Dale Allen Maxville Jr., PHD BCBA-D
• Amanda Maxwell, M.S.N., R.N.
• George Benjamin Maxwell, B.A.
• Kathleen Maxwell, LPC
• Kelly Ann Maxwell, MAC
• Marilyn A. Maxwell, M.D.
• Marjorie D Maxwell, R.D.
• Adam Maurice May, MD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, 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 Dec 15, 2020; 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.