ST LOUIS SOUTH ORTHODONTICS (NPI# 1699281121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699281121 |
| Entity Type | Organization |
| Organization Name | ST LOUIS SOUTH ORTHODONTICS |
| Practice Address |
9911 Kennerly Rd Ste H Saint Louis MO 63128-2700 |
| Practice Telephone | 3148435583 |
| Practice Fax Number | 3148436495 |
| Mailing Telephone | 3148435583 |
| Mailing Fax Number | 3148436495 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |
| Authorized Official Name | DR. SENTHIL N ARUN (OWNER) |
| Authorized Official Telephone | 7062887538 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
2013009439 | MO | Dental Providers |
| Street Address |
9911 KENNERLY RD STE H |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128-2700 |
| 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 | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023556743 | Mark Humphrey | Dentist | 8657 Old Bonhomme Rd, Saint Louis, MO 63132-3901 | 2017-02-01 |
| 1730434192 | Nefeli Vasilakou | Dentist | 3320 Rutger Street, Saint Louis, MO 63104 | 2012-07-20 |
| 1306115647 | Edward J Shaheen Jr. | Dentist | 10363 Clayton Rd, Saint Louis, MO 63131-2907 | 2011-12-15 |
| 1053538504 | E. Glenn Glassman, D.d.s. PC Dba Orthocare Systems | Dentist | 6925 S Lindbergh Blvd, Saint Louis, MO 63125-4220 | 2007-04-19 |
| 1417174954 | E. Glenn Glassman D.d.s. PC Dba Orthocare Systems | Dentist | 10413 W Florissant Ave, Saint Louis, MO 63136-2342 | 2007-04-19 |
| 1700909991 | Stephen Gerard Nikodem | Dentist | 4116 Von Talge Rd Ste A, Saint Louis, MO 63128-1957 | 2007-04-10 |
| 1295873214 | Heidi Marie Butts | Dentist | 8760 Big Bend Blvd, Saint Louis, MO 63119-3730 | 2007-02-02 |
| 1497838163 | Debra F Fink | Dentist | 13302 Manchester Rd, Saint Louis, MO 63131-1709 | 2006-10-24 |
| 1093810202 | Mazyar Moshiri | Dentist | 777 S. New Ballas Road, Suite 116e, Saint Louis, MO 63141 | 2006-09-13 |
| 1215046008 | Richard James Nissen | Dentist | 31 The Boulevard-st. Louis, Saint Louis, MO 63117 | 2006-08-29 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
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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.