MARSHALL CORNELIUS FREERKS JR. (NPI# 1346488236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346488236 |
| Entity Type | Individual |
| Full Name | MARSHALL CORNELIUS FREERKS JR. |
| Credential | DDS |
| Practice Address |
6744 Clayton Rd. Suite 204 St. Louis MO 63117-1634 |
| Practice Telephone | 3147255515 |
| Mailing Telephone | 3147255515 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 14600 | MO | Dental Providers |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
14600 | MO | Ambulatory Health Care Facilities |
| Street Address |
6744 CLAYTON RD. SUITE 204 |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63117-1634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1215491329 | Latonya Allen | Counselor | 1612 S. Big Bend Blvd, St. Louis, MO 63117 | 2019-01-23 |
| 1265917025 | Blue Stars Therapy, LLC | Occupational Therapist | 1101 Edward Terrace, Apt A, St. Louis, MO 63117 | 2018-09-27 |
| 1770060014 | Ultra Care Home Services LLC | Home Health | 7353 Dale Ave, Saint Louis, MO 63117 | 2018-07-19 |
| 1235623562 | Melissa Valerie Taylor | Counselor | Psychological Services of St Louis, LLC, 7110 Oakland Ave, St Louis, MO 63117 | 2018-06-20 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| Find all providers in zip 63117 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444740 | Ressel Family Dentistry LLC | Clinic/Center | 1 E Broadway Ste A, Columbia, MO 65203-4205 | 2020-10-16 |
| 1467059980 | Valudental Independence LLC | Clinic/Center | 600 E Us Highway 24, Independence, MO 64050-2910 | 2020-10-07 |
| 1144835828 | Rem Dds, LLC | Clinic/Center | 10000 Watson Rd Ste 2mm, Saint Louis, MO 63126-1848 | 2020-09-10 |
| 1043824832 | Pleasant Dental Care Kc | Clinic/Center | 912 E 63rd St Ste 100, Kansas City, MO 64110-3439 | 2020-08-31 |
| 1164033122 | Dental Depot of Blue Springs Pllc | Clinic/Center | 1500 S 7 Hwy, Blue Springs, MO 64014-3943 | 2020-08-13 |
| 1184235517 | Twin Creeks Family Dentistry LLC | Clinic/Center | 10560 N Ambassador Dr Ste 200, Kansas City, MO 64153-1591 | 2020-08-10 |
| 1003434234 | Jason L Allen Dmd LLC | Clinic/Center | 5147 Daggett Ave, Saint Louis, MO 63110-3009 | 2020-07-14 |
| 1538622071 | Smile Safari of Missouri | Clinic/Center | 10016 E 63rd St, Raytown, MO 64133-5102 | 2019-04-11 |
| 1275094864 | Itooth Family Dentistry, LLC | Clinic/Center | 3211 E Battlefield St Ste 100, Springfield, MO 65804-4071 | 2019-03-27 |
| 1033677901 | C. Hastings, Dds, LLC | Clinic/Center | 1709 Heritage Hills Dr, Washington, MO 63090-4621 | 2019-03-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MARSHALL CORNELIUS FREERKS JR..
| 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.