DR. MARIUS ANTONIO EVANS (NPI# 1245629302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245629302 |
| Entity Type | Individual |
| Full Name | DR. MARIUS ANTONIO EVANS |
| Credential | D.D.S. |
| Practice Address |
9911 Kennerly Rd. Suite G St. Louis MO 63128 |
| Practice Telephone | 3148490999 |
| Practice Fax Number | 3148491385 |
| Mailing Telephone | 3148490999 |
| Mailing Fax Number | 3148491385 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE015685 | MO | Dental Providers |
| Street Address |
9911 KENNERLY RD. SUITE G |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63128 |
| 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 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| 1831464130 | Shaun B Hanson | Internal Medicine | 10012 Kennerly Rd Ste 102, Saint Louis, MO 63128 | 2012-03-20 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811369499 | Tyler Musto | Dentist | 120000 Bellefontaine, St. Louis, MO 63138 | 2015-10-22 |
| 1447699335 | Beth Renee Groenke | Dentist | 1403 Hampton Ave, St. Louis, MO 63139 | 2013-06-24 |
| 1245544709 | Nick Azar | Dentist | 4615 Lindell Blvd, #901, St. Louis, MO 63108 | 2010-07-27 |
| 1104066604 | Louise R First | Dentist | 77 Westport Plaza Drive, Suite 205, St. Louis, MO 63146 | 2009-02-24 |
| 1174762850 | Antonio I Longrais | Dentist | 4600 S. Lindbeigh 63127, St. Louis, MO 63127 | 2009-02-19 |
| 1346488236 | Marshall Cornelius Freerks Jr. | Dentist | 6744 Clayton Rd., Suite 204, St. Louis, MO 63117-1634 | 2009-01-30 |
| 1780707034 | William Anthony Taylor Sr. | Dentist | 9730 E Watson Rd, Suite # 1, St. Louis, MO 63126 | 2007-04-09 |
| 1063561769 | Christopher Bradley Hill | Dentist | 1113 Locust Street, St. Louis, MO 63101 | 2007-01-10 |
| 1962584565 | Scott Douglas Klohr | Dentist | 1608 S. Big Bend, St. Louis, MO 63117-2208 | 2006-10-20 |
| 1508973892 | Linzi Anne Cavanaugh | Dentist | 809 S. Lindbergh, St. Louis, MO 63131 | 2006-08-24 |
| Find all providers in ST. LOUIS | ||||
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| 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.