SOUTH COUNTY DENTAL IMAGING CENTER (NPI# 1053647008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053647008 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY DENTAL IMAGING CENTER |
| Practice Address |
12818 Tesson Ferry Rd Suite 204 Saint Louis MO 63128-2945 |
| Mailing Address |
1034 S Brentwood Blvd Suite 1010 Saint Louis MO 63117-1223 |
| Practice Telephone | 3147222033 |
| Practice Fax Number | 3148421590 |
| Mailing Telephone | 3147211010 |
| Mailing Fax Number | 3147215276 |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2009-10-27 |
| Authorized Official Name | DR. JOHN R MONTERUBIO SR. (PRESIDENT) |
| Authorized Official Telephone | 3147211010 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Street Address |
12818 TESSON FERRY RD SUITE 204 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922002344 | Loren Clayton Schrenk | Ophthalmology | 12818 Tesson Ferry Rd, Ste 201, Saint Louis, MO 63128-2945 | 2005-06-13 |
| 1700208782 | Elizabeth Dunn Babcock | Dietitian, Registered | 12818 Tesson Ferry Rd, Suite 104, Saint Louis, MO 63128-2945 | 2014-01-10 |
| 1962751750 | Christopher T James | Hearing Instrument Specialist | 12818 Tesson Ferry Rd, Ste 205, Saint Louis, MO 63128-2945 | 2012-09-07 |
| 1629205539 | The Center for Health & Wellness, LLC | Specialist | 12818 Tesson Ferry Rd, Suite 101, Saint Louis, MO 63128-2945 | 2009-06-18 |
| 1336301142 | The Center for Health and Wellness | Psychiatry & Neurology | 12818 Tesson Ferry Rd, Suite 101, Saint Louis, MO 63128-2945 | 2008-07-02 |
| 1063636934 | Mark Andrew Mcclure | Dentist | 12818 Tesson Ferry Rd, Suite 202, Saint Louis, MO 63128-2945 | 2007-04-12 |
| 1699806919 | Eyecare Management LLC | Optometrist | 12818 Tesson Ferry Rd, Suite 201, Saint Louis, MO 63128-2945 | 2007-03-08 |
| 1093846347 | Eye Consultants of Il Ltd | Ophthalmology | 12818 Tesson Ferry Rd, Suite 201, Saint Louis, MO 63128-2945 | 2007-03-08 |
| 1417917881 | Daniel J. Mueth | Dentist | 12818 Tesson Ferry Rd, Suite 102, Saint Louis, MO 63128-2945 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215326574 | Walker Medical Building Mri Services, LLC | Clinic/Center | 12855 N 40 Dr Lowr Level, Saint Louis, MO 63141-8657 | 2015-01-09 |
| 1194776815 | Midwest Medical Associates, Inc | Clinic/Center | 3825 S Lindbergh Blvd, Saint Louis, MO 63127-1356 | 2006-05-15 |
| 1851632566 | Emerson Road Imaging Center LLC | Clinic/Center | 633 Emerson Rd, Saint Louis, MO 63141-6739 | 2013-03-05 |
| 1942508023 | Pearl Imaging, LLC | Clinic/Center | 450 N New Ballas Rd, Suite 20-ll, Saint Louis, MO 63141-6835 | 2011-03-14 |
| 1962432492 | Signature Health Services | Clinic/Center | 12639 Old Tesson Rd, Suite 115, Saint Louis, MO 63128-2786 | 2006-07-03 |
| 1952347049 | Midwest Medical Associates Inc. | Clinic/Center | 7345 Watson Rd, Saint Louis, MO 63119-4405 | 2006-06-20 |
| 1427000405 | Vista Imaging Partners, LLC | Clinic/Center | 655 Craig Rd, Suite 112, Saint Louis, MO 63141-7132 | 2006-05-17 |
| 1962460428 | Jsm Enterprises, LLC | Clinic/Center | 450 N New Ballas Rd, Ste. 250, Saint Louis, MO 63141-6835 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336633304 | Midwest Imaging Specialists | Clinic/Center | 201 S Mount Auburn Rd Ste B, Cape Girardeau, MO 63703-4912 | 2018-06-21 |
| 1922480110 | Eric Edwin Klein | Clinic/Center | 400 Stallion Hill Ct, Chesterfield, MO 63005-4838 | 2015-06-24 |
| 1255728226 | Harry S. Truman Mvh | Clinic/Center | 132 Southampton Dr, Columbia, MO 65203-3050 | 2015-04-17 |
| 1558617035 | Hi Tech Diagnostics LLC | Clinic/Center | 16502 Barrister Ln, Chesterfield, MO 63005-4602 | 2012-08-02 |
| 1386945665 | West Central Missouri Diagnostic | Clinic/Center | 1430 Thompson Blvd Ste 7, Sedalia, MO 65301-2209 | 2010-11-03 |
| 1437476900 | Pearl Imaging, LLC | Clinic/Center | 4293 Veterans Memorial Pkwy, Saint Peters, MO 63376-1657 | 2010-04-23 |
| 1659504116 | Mri Partners of Chesterfield, LLC. | Clinic/Center | 14825 North Outer Forty Road, Suite 110, Chesterfield, MO 63017-2026 | 2009-09-01 |
| 1720232192 | Elite Imaging of North County, LLC | Clinic/Center | 433 Lynn Haven Ln, Hazelwood, MO 63042-1808 | 2008-11-11 |
| 1164647657 | Ct Partners of Chesterfield, LLC | Clinic/Center | 14825 North Outer Forty Rd., Ste 110, Chesterfield, MO 63017-2026 | 2007-04-17 |
| 1093854358 | Moberly Radiology & Imaging I, LLC | Clinic/Center | 1509 Union Ave, Moberly, MO 65270-9407 | 2007-02-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on SOUTH COUNTY DENTAL IMAGING CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.