PEDAITRIC DENTAL AND ORTHODONTIC ASSOCIATES OF ST LOUIS (NPI# 1780989061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780989061 |
| Entity Type | Organization |
| Organization Name | PEDAITRIC DENTAL AND ORTHODONTIC ASSOCIATES OF ST LOUIS |
| Practice Address |
430 S Clay Ave Kirkwood MO 63122-5808 |
| Practice Telephone | 3149657630 |
| Mailing Telephone | 3149657630 |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2011-01-19 |
| Authorized Official Name | DR. THOMAS VERALDI (OWNER) |
| Authorized Official Telephone | 3149657630 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
14227 | MO | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
14227 | MO | Dental Providers |
| Street Address |
430 S CLAY AVE |
| City | KIRKWOOD |
| State | MO |
| Zip Code | 63122-5808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659933174 | Keela Rushing | Physical Therapist | 439 S Kirkwood Rd Ste 200, Kirkwood, MO 63122 | 2019-07-04 |
| 1730643461 | Kirkwood Family Dental | Dentist | 333 S Kirkwood Road, Suite 105, Kirkwood, MO 63122 | 2019-01-28 |
| 1477061166 | Total Access Urgent Care, PC | Clinic/Center | 2980 Dougherty Ferry Rd, Saint Louis, MO 63122 | 2018-01-16 |
| 1760933469 | Missouri Cvs Pharmacy, L.l.c | Durable Medical Equipment & Medical Supplies | 10820 Manchester Rd, Kirkwood, MO 63122 | 2016-10-18 |
| 1518321041 | M. Kathleen Blanchard | Counselor | 11042 Manchester Rd., Kirkwood, MO 63122 | 2016-04-11 |
| 1265801914 | Kim Grega | Counselor | 700 S Kirkwood Rd, Kirkwood, MO 63122 | 2015-09-23 |
| 1245617943 | Mark Edward Taylor | Dentist | 610 North Geyer, Kirkwood, MO 63122 | 2015-05-01 |
| 1467843094 | Mary Elizabeth Boomgarden | Physical Therapist | 9645 Big Bend Boulevard, Saint Louis, MO 63122 | 2015-02-18 |
| 1760725717 | Michael Diller Counseling | Counselor | 144 W Madison Avenue, Kirkwood, MO 63122 | 2013-03-28 |
| 1427309954 | Anne Marie Delaplain | Dentist | 725 Laclede Station Road, Webster Groves, MO 63122 | 2012-09-24 |
| Find all providers in zip 63122 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366068009 | Hometown Pediatric Dentistry LLC | Dentist | 301 S Platte Clay Way Ste A, Kearney, MO 64060-8826 | 2020-06-18 |
| 1710539937 | M. Pratt, Dds, LLC | Dentist | 11709 Old Ballas Rd Ste 200, Saint Louis, MO 63141-7029 | 2019-07-09 |
| 1619471356 | Allison W Buford | Dentist | 2325 Dougherty Ferry Rd Ste 200, Saint Louis, MO 63122-3356 | 2018-03-19 |
| 1972014504 | Rock Dental Missouri LLC | Dentist | 181 N Kentucky Ave Ste 300, West Plains, MO 65775-2092 | 2017-10-23 |
| 1811408479 | Waldo Pediatric Dentistry | Dentist | 8043 Wornall Rd Ste 202, Kansas City, MO 64114-5822 | 2017-10-22 |
| 1437668126 | Como Pediatric Dentistry LLC | Dentist | 1316 Old 63 S Ste 201, Columbia, MO 65201-6092 | 2017-09-25 |
| 1053848374 | Summit Pediatric Dentistry | Dentist | 24 Nw Chipman Rd Ste B, Lees Summit, MO 64063-1929 | 2017-05-17 |
| 1043741309 | Unruh Pediatric Dentistry LLC | Dentist | 717 N Highway 7, Blue Springs, MO 64014-6426 | 2017-03-27 |
| 1932552528 | Gerard Feldhaus Dds PC | Dentist | 415 E 69th Ter, Kansas City, MO 64131-1330 | 2016-07-19 |
| 1356721518 | Christopher Drake | Dentist | 1205 Ne Coronado Dr, Blue Springs, MO 64014-2928 | 2015-06-03 |
| Find all providers with the same taxonomy | ||||
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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.