Michael James Pernoud, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12314 Issued in MO

Practice address

1015 Washington SQ
Washington, MO 63090-5307

Phone

(636) 239-5959

Fax

(636) 239-7586

NPI assigned

Feb 26, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael J Pernoud DDS PC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Washington, MO
  • NPI 1659538973
  NPD (past) Authorized official

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

{
    "created_epoch": "1140912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962478305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-5959",
            "fax_number": "636-239-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 WASHINGTON SQ",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630905307",
            "telephone_number": "636-239-5959",
            "fax_number": "636-239-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNOUD",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "12314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patients First Surgery Center LLC
• Rachel L Payne, PTA
• Frederick Joseph Peet Jr., D.P.M.
• Kelly Ann Peplinski, M.A., LPC
• Rhonda Ann Pepmiller, ANP-BC,CWOCN
• John R Douglas Peterson, M.D.
• Gregory Pfitzer, DO
• Pharmax Partners Inc. (Schroeder's Long-Term Care)
• Pharmax Partners Inc. (Schroeder Drugs #1201)
• Pharmax Partners Inc. (Schroeder Drugs #1201)

• Oral and Maxillofacial Surgery (Dentist) in Washington, MO
• Providers in Washington, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.