NPIMap

Organization Active NPI

Washington Square Dental

  • General Practice Dentistry
  • Washington, MO
National Provider Identifier
1891987954
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2004013254 Issued in MO
Legal business name
WASHINGTON SQUARE DENTAL
Practice address
1015 Washington SQ Ste E
Washington, MO 63090-5307
Phone
(636) 239-7828
Fax
(636) 239-5048
NPI assigned
Aug 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Dr. Melissa Ann Smith, D.D.S, P.C.
Title
Owner
Phone
(636) 239-7828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2004013254 MO Primary

Addresses

Primary practice location

1015 Washington SQ Ste E
Washington, MO 63090-5307

Mailing address

1015 Washington SQ Ste E
Washington, MO 63090-5307
Phone (636) 239-7828

National Provider Directory

National Provider Directory
Tax ID family
Washington Smiles Complete Health Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1891987954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ STE E",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-7828",
            "fax_number": "636-239-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ STE E",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-7828",
            "fax_number": "636-239-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON SQUARE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-239-7828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, P.C."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2004013254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.