REZA MOVAHED DMD, LLC (NPI# 1740703842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740703842 |
| Entity Type | Organization |
| Organization Name | REZA MOVAHED DMD, LLC |
| Other Organization Name | MOVAHED OMS |
| Practice Address |
1585 Woodlake Dr Ste 208 Chesterfield MO 63017-5740 |
| Practice Telephone | 3148786725 |
| Practice Fax Number | 3148786726 |
| Mailing Telephone | (314) 878-6725 |
| Mailing Fax Number | 3148786726 |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | REZA MOVAHED (OWNER) |
| Authorized Official Telephone | 3148786725 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mid America Oral Surgery and Implant Center | Doing Business As Name - Organization |
| Movahed OMS | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 624 Pierce Blvd Ste 200, O Fallon, IL 622692582 | 6182062630 | 6182062631 |
| Street Address |
1585 WOODLAKE DR STE 208 |
| City | CHESTERFIELD |
| State | MO |
| Zip Code | 63017-5740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790923365 | Reza Movahed | Dentist | 1585 Woodlake Dr Ste 208, Chesterfield, MO 63017-5740 | 2009-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114549193 | Kathryn E Bos | Student in an Organized Health Care Education/Training Program | 873 Apt N Foxsprings Dr, Chesterfield, MO 63017 | 2020-05-12 |
| 1700415171 | Charles H. Edwards | Physical Therapist | 224 South Woods Millrd., Suite 610 South, Chesterfield, MO 63017 | 2020-04-07 |
| 1003454562 | Stephanie Henningsen | Physical Therapy Assistant | 307 S Woods Rd, Chesterfield, MO 63017 | 2019-12-16 |
| 1831746296 | Star Lynn Sutton | Occupational Therapy Assistant | 15207 Olive Boulevard, Chesterfield, MO 63017 | 2019-08-21 |
| 1639738438 | Van Amburg & Busiek Md's, LLC | Pharmacy | 232 S Woodsmill Road, Suite 330 East, Chesterfield, MO 63017 | 2019-06-06 |
| 1306306865 | Margaret Mary Wynn | Nurse Practitioner | 15740 South Outer Road, Chesterfield, MO 63017 | 2019-03-21 |
| 1205393089 | Kimberly Danielle | Nurse Practitioner | 744 Forest Trace Dr, Chesterfield, MO 63017 | 2019-02-27 |
| 1457823965 | Allison Joy Mcgrail | Dietitian, Registered | 45740 S Outer Forty Rd, Chesterfield, MO 63017 | 2018-12-21 |
| 1316418080 | Julie Lefere | Social Worker | Mercy Virtual Care Center, 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2018-12-06 |
| 1336629641 | Catherine Dolphin Smith | Nurse Practitioner | 224 S Woods Mill Rd Ste 500, Chesterfield, MO 63017 | 2018-08-16 |
| Find all providers in zip 63017 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| City | CHESTERFIELD |
| Zip Code | 63017 |
Please comment or provide details below to improve the information on REZA MOVAHED DMD, LLC.
| 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.