Active NPI
Jacqueline Anne Demko, DDS MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chesterfield, MO
National Provider Identifier
1942391065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 015993
- Practice address
- 14377 Woodlake Drive
Ste 216
Chesterfield, MO 63017 - Phone
- (314) 576-4955
- Fax
- (314) 576-3811
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 015993 | MO | Primary |
Addresses
Primary practice location
14377 Woodlake Drive
Ste 216
Chesterfield, MO 63017
Mailing address
671 Stonebrook CT
Chesterfield, MO 63005
Phone (314) 576-4955
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015993 | MO | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Demko Orthodontics LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Chesterfield, MO
- NPI 1356413611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942391065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "671 STONEBROOK CT",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "63005",
"telephone_number": "314-576-4955",
"fax_number": "314-576-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14377 WOODLAKE DRIVE",
"address_2": "STE 216",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "63017",
"telephone_number": "314-576-4955",
"fax_number": "314-576-3811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMKO",
"first_name": "JACQUELINE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MO",
"license": "015993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MO
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.