Mid-America Dental Sleep Medicine LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

013936 Issued in MO

Legal business name

MID-AMERICA DENTAL SLEEP MEDICINE LLC

Practice address

1507 Heritage Hills Dr
Washington, MO 63090-4614

Phone

(636) 239-5151

Fax

(636) 390-2728

NPI assigned

Jun 10, 2014

Last updated

Jun 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kevin C Walde, DDS MSNPI 1649472465

Title

Owner

Phone

(636) 239-5151

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin C Walde, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Washington, MO
  • NPI 1649472465
  Authorized official Same address or phone

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1952714792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 HERITAGE HILLS DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904614",
            "telephone_number": "636-239-5151",
            "fax_number": "636-390-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 HERITAGE HILLS DR",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904614",
            "telephone_number": "636-239-5151",
            "fax_number": "636-390-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-AMERICA DENTAL SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "WALDE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-239-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "013936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena Bronakowska Mertz, DDS
• Donna Ann Meyer, M.D./AP
• Sharise Meyer, CNM
• Michael J Pernoud DDS PC
• Michelle L. Beumer, PC (Riverside Pediatrics)
• Mid-West Podiatry and Associates, LLC
• Tracie Adele Miles, MA LPC
• Jacqueline Marie Miller, DDS, MS
• Susan Miller, PT
• Evan Matthew Milner, DO

• Orthodontics and Dentofacial Orthopedics Dentistry in Washington, MO
• Providers in Washington, MO by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.