KEVIN D. BURGDORF DDS LLC (NPI# 1689042467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689042467 |
| Entity Type | Organization |
| Organization Name | KEVIN D. BURGDORF DDS LLC |
| Practice Address |
12266 Depaul Drive Suite 325 Bridgeton MO 63044-2514 |
| Practice Telephone | 3142919000 |
| Practice Fax Number | 3142910590 |
| Mailing Telephone | 3142919000 |
| Mailing Fax Number | 3142910590 |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |
| Authorized Official Name | DR. KEVIN D BURGDORF (OWNER) |
| Authorized Official Telephone | 3142919000 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 2009008266 | MO | Dental Providers |
| Street Address |
12266 DEPAUL DRIVE SUITE 325 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548252000 | Angela Cartwright | Obstetrics & Gynecology | 12266 Depaul Drive, Suite 200, Bridgeton, MO 63044 | 2005-08-19 |
| 1982258687 | Julia Wagner | Nurse Practitioner | 12266 Depaul Drive, Suite 100, Bridgeton, MO 63044 | 2019-07-31 |
| 1508301565 | Richard Johnson | Pharmacist | 12266 Depaul Drive, Suite 105, Bridgeton, MO 63044 | 2016-12-30 |
| 1043760259 | Anne Marie Phillips | Nurse Practitioner | 12266 Depaul Drive, Suite 100, Bridgeton, MO 63044 | 2016-10-12 |
| 1780077172 | Kimberly Anno | Nurse Practitioner | 12266 Depaul Drive, Suite 200, Bridgeton, MO 63044 | 2015-03-10 |
| 1174962922 | Ssm Depaul Medical Group | Orthopaedic Surgery | 12266 Depaul Drive, Suite 110, Bridgeton, MO 63044-2514 | 2013-06-14 |
| 1609131663 | Seth Hepner | Internal Medicine | 12266 Depaul Drive, Bridgeton, MO 63044 | 2012-07-05 |
| 1942596002 | Physicians' Ambulatory Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 12266 Depaul Drive, Bridgeton, MO 63044-2514 | 2011-06-27 |
| 1033427257 | Patricia Bozzi | Specialist | 12266 Depaul Drive, Suite 115, Bridgeton, MO 63044 | 2010-09-22 |
| 1598072613 | Emily Terese Britt | Physical Therapist | 12266 Depaul Drive, Suite 115, Bridgeton, MO 63044 | 2010-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| 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 |
|---|---|---|---|---|
| 1134649312 | Steven Jamaal Keglar | Dentist | 12221 Saint Charles Rock Rd, Bridgeton, MO 63044-2502 | 2017-06-20 |
| 1225413511 | Cindy Kong | Dentist | 102 Old Deerfield Pike, Bridgeton, NJ 08302-3703 | 2015-07-28 |
| 1750784054 | Aspen Dental | Dentist | 12221 St. Charles Rock Rd, Bridgeton, MO 63044 | 2014-09-30 |
| 1487888582 | Christine Marie Vitello | Dentist | 3458 Mckelvey, Bridgeton, MO 63044 | 2009-05-05 |
| 1962628644 | Jary T Klein | Dentist | 12147 Natural Bridge Rd, Bridgeton, MO 63044-2018 | 2007-04-18 |
| 1376662411 | Robert A Katsev | Dentist | 3478 Bridgeland Dr Suite #3, Bridgeton, MO 63044 | 2007-03-28 |
| 1013043348 | L Marilyn Weaks | Dentist | 3394 Mckelvey Road, Suite 115, Bridgeton, MO 63044 | 2007-02-23 |
| 1164563367 | Marietta Donahue | Dentist | 21 No Burlington Rd, Southwood State Prison Allcare, Bridgeton, NJ 08302 | 2007-02-09 |
| 1669521118 | Richard Willet Boss Jr. | Dentist | 553 Shiloh Pike, Bridgeton, NJ 08302-1405 | 2007-01-10 |
| 1033296132 | Marzban G Patel | Dentist | 12255 De Paul Drive, Suite 745, Bridgeton, MO 63044 | 2006-11-01 |
| Find all providers in BRIDGETON | ||||
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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.