DR. JEROME SHATOFF (NPI# 1194875666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194875666 |
| Entity Type | Individual |
| Full Name | DR. JEROME SHATOFF |
| Credential | DDS |
| Practice Address |
204 S Clay Ave Kirkwood MO 63122 |
| Practice Telephone | 3148212650 |
| Practice Fax Number | 3148215141 |
| Mailing Telephone | 3148212650 |
| Mailing Fax Number | 3148215141 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
12459 | MO | Dental Providers |
| Street Address |
204 S CLAY AVE |
| City | KIRKWOOD |
| State | MO |
| Zip Code | 63122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033201975 | Charles Beard | Dentist | 204 S Clay Ave, Kirkwood, MO 63122-4207 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629605019 | Bhavika V Thakkar | Dentist | 650 E 25th St Rm 277, Kansas City, MO 64108-2716 | 2020-03-25 |
| 1285159004 | C. Alan Mcquigg Dds Ms PC | Dentist | 620 W 32nd St Ste C, Joplin, MO 64804-2528 | 2017-08-14 |
| 1770011926 | Azadeh Afshari, Dds LLC | Dentist | 517 S Euclid Ave Bldg Ste 819, Saint Louis, MO 63110-1007 | 2017-06-01 |
| 1487958112 | Carol Kim | Dentist | 3842 S Glenstone Ave, Springfield, MO 65804-4418 | 2011-01-11 |
| 1972750909 | Kevin D Wallace | Dentist | 1200 E Woodhurst Dr Ste A200, Springfield, MO 65804-3745 | 2008-08-21 |
| 1235322108 | Glen H Petteway | Dentist | 1200 E Woodhurst, Ste T300, Springfield, MO 65804-3784 | 2007-08-23 |
| 1881899466 | Warren Henry Speiser | Dentist | 885 St Francois Street, Florissant, MO 63031-4923 | 2007-06-15 |
| 1134282023 | Kristine Kae Schrock | Dentist | 3906 Sherman Ave, Saint Joseph, MO 64506-3648 | 2006-12-19 |
| 1487740189 | Kyle Donahue | Dentist | 2020 Bluestone Dr, Saint Charles, MO 63303-5974 | 2006-10-04 |
| 1093738858 | Richard Blustein | Dentist | 711 N New Ballas Rd, Saint Louis, MO 63141-6715 | 2006-07-25 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. JEROME SHATOFF.
| 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.