Thomas Milton Runco, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2014030147 Issued in MO

Practice address

64 Crestwood Executive Ctr
Saint Louis, MO 63126-1904

Phone

(314) 843-0470

Fax

(314) 843-0438

NPI assigned

Aug 26, 2014

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1962802082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 CRESTWOOD EXECUTIVE CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261904",
            "telephone_number": "314-843-0470",
            "fax_number": "314-843-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CRESTWOOD EXECUTIVE CTR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631261904",
            "telephone_number": "314-843-0470",
            "fax_number": "314-843-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNCO",
        "first_name": "THOMAS",
        "middle_name": "MILTON",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2014030147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisreen S.I. Rumman, MD
• Katherine Rummel
• Emily Rumora, MD
• Ashley L Rumsey, APRN, AGCNS-BC
• Frank Anthony Runco, DMD
• John Lucas Runde
• Kelley Runde, APRN-CNP PMHNP-BC
• Michelle Lee Runge, COTA
• Tamara Joan Runge
• Panvathu Rungsiyaphornratana, MD

• General Practice Dentistry in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.