Jennifer A. Plessner, D.D.S.
Individual provider Active NPI General Practice Dentistry · O'Fallon, MO
NPI 1992826754 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992826754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 015604 (MO)
- Practice address
- 2141 West Terra Lane
O'Fallon, MO 63366 - Phone
- (636) 332-3322
- Fax
- (636) 639-9384
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160414001150 | MO | Order and Referring Only - Dentist |
0941508501 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeview Dental LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 015604 | MO | Yes |
Addresses
Primary practice location
2141 West Terra Lane
O'Fallon, MO 63366
Mailing address
2141 West Terra Lane
O'Fallon, MO 63366
Phone (636) 332-3322
Other providers in O'Fallon, MO
- Outreach Specialty Physicians LLC
- Linda R Partridge
- Physician Groups LC
- Physician Groups LC
- John Wayne Platt
- Progress West Healthcare Center
- Reetika Puri
- Qi Enterprises
- Michelle Rega
- Matthew E Reyering
All providers in O'Fallon, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.