NPIMap

Organization Active NPI

Westport Periodontics P.C.

  • Periodontics
  • Saint Louis, MO
National Provider Identifier
1902953391
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
WESTPORT PERIODONTICS P.C.
Practice address
77 Westport PLZ
Suite 367
Saint Louis, MO 63146-3107
Phone
(314) 434-4676
Fax
(314) 434-6806
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. George H. Kyd III, D.D.S.NPI 1982751392
Title
President
Phone
(314) 434-4676

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X MO Primary

Addresses

Primary practice location

77 Westport PLZ
Suite 367
Saint Louis, MO 63146-3107

Mailing address

77 Westport PLZ
Suite 367
Saint Louis, MO 63146-3107
Phone (314) 434-4676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902953391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WESTPORT PLZ",
            "address_2": "SUITE 367",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463107",
            "telephone_number": "314-434-4676",
            "fax_number": "314-434-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WESTPORT PLZ",
            "address_2": "SUITE 367",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463107",
            "telephone_number": "314-434-4676",
            "fax_number": "314-434-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTPORT PERIODONTICS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KYD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-434-4676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.