Active NPI
Stephen Arthur Moelling, DDS
- General Practice Dentistry
- Ballwin, MO
National Provider Identifier
1902816614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11736
- Practice address
- 15459 Clayton Rd
Ballwin, MO 63011-3125 - Phone
- (636) 391-8646
- Fax
- (636) 391-3365
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11736 | MO | Primary |
Addresses
Primary practice location
15459 Clayton Rd
Ballwin, MO 63011-3125
Mailing address
15459 Clayton Rd
Ballwin, MO 63011-3125
Phone (636) 391-8646
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 |
|---|---|---|---|
| 11736 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902816614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15459 CLAYTON RD",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113125",
"telephone_number": "636-391-8646",
"fax_number": "636-391-3365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15459 CLAYTON RD",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113125",
"telephone_number": "636-391-8646",
"fax_number": "636-391-3365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOELLING",
"first_name": "STEPHEN",
"middle_name": "ARTHUR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "11736",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
- Missouri CVS Pharmacy, L.L.C.
- Missouri CVS Pharmacy, L.L.C.
- Missouri CVS Pharmacy, L.L.C.
- Missouri Dental Professionals, Richard Straus, DMD, PC
- Lori A Mitchell, LPN
- Masarrath Jahan Moinuddin
- Kevin Moreno, DDS
- Morgenrote, LLC Dba Homewell Care Services Mo 0331
- Gretchen Leigh Morris, P.T.
- Tia Jenice Morris, MSW, ACSW, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.