Dde LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DDE LLC

Doing business as

Advanced Family Dental

Practice address

12758 Boenker LN
Bridgeton, MO 63044-2436

Phone

(314) 739-3300

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Terry R Egan, DDS

Title

Member

Phone

(314) 739-3300

Specialties & licenses 1

Addresses

Other names 1

• Advanced Family Dental Doing business as

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922123652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12758 BOENKER LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442436",
            "telephone_number": "314-739-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12758 BOENKER LN",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442436",
            "telephone_number": "314-739-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-739-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lana Dasilva Allen, P.T.
• Erin Marie Davidson, MOT, OTR/L
• John C Davis, M.D.
• Nicholas Davis II
• Sandra Davis
• Nivi Dean, DPT
• Mackenzie Dear, DPT
• Julie Deibel, PHARMD
• Lauren Elizabeth Deichmann, FNP-BC
• Kelly Dejarnett

• Dentist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Dentist in Missouri

• 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.