GREIF RUVINOV DENTAL CARE, LLC (NPI# 1790276764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790276764 |
| Entity Type | Organization |
| Organization Name | GREIF RUVINOV DENTAL CARE, LLC |
| Other Organization Name | BROOKSIDE FAMILY DENTISTRY |
| Practice Address |
31 Ofallon Sq O Fallon MO 63366-3034 |
| Practice Telephone | 6362401750 |
| Practice Fax Number | 6363895442 |
| Mailing Telephone | 6362401750 |
| Mailing Fax Number | 6363895442 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | STACY M MARTIN (OFFICE MANAGER) |
| Authorized Official Telephone | 6362401750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Brookside Family Dentistry | Doing Business As Name - Organization |
| Street Address |
31 OFALLON SQ |
| City | O FALLON |
| State | MO |
| Zip Code | 63366-3034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1073026670 | Winemiller Family Dentistry, LLC | Clinic/Center | 31 Ofallon Sq, O Fallon, MO 63366-3034 | 2017-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407314826 | Transformative Health 180 LLC | Physical Therapist | 821 West Terra Lane, O Fallon, MO 63366 | 2019-03-05 |
| 1740754126 | Donna Marie Person | Nurse Practitioner | 331 Magnolia Valley Dr., Ofallon, MO 63366 | 2019-01-18 |
| 1679069470 | Samantha Schulte | Clinical Pharmacology | 7 Poor Richard Ct, O Fallon, MO 63366 | 2018-07-03 |
| 1790218048 | Jill Buery | Marriage & Family Therapist | 801 S Woodlawn Ave, Ste 15, O'fallon, MO 63366 | 2017-04-04 |
| 1114466968 | Jessica Anne Morris | Counselor | 103 Lincoln Street, O'fallon, MO 63366 | 2017-02-13 |
| 1295116143 | Katherine Seiler Harkess | Obstetrics & Gynecology | 300 Winding Woods Drive Suite 200, O'fallon, MO 63366 | 2015-06-16 |
| 1528453354 | Amanda Flamm | Nurse Practitioner | 1101 Hightway K, Ofallon, MO 63366 | 2015-03-30 |
| 1144639972 | Sara Birkemeier | Physical Therapist | 1541 Norwood Hills Dr, Ofallon, MO 63366 | 2014-08-06 |
| 1710390893 | Catherine Rose Most | Speech-Language Pathologist | 555 E. Terra Lane, Fort Zumwalt School District, O'fallon, MO 63366 | 2014-06-06 |
| 1386070803 | Rachael Elizabeth Wilson | Counselor | 1137 North Main Street, Suite 2, Ofallon, MO 63366 | 2013-09-16 |
| Find all providers in zip 63366 | ||||
| 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 |
|---|---|---|---|---|
| 1003428335 | Ralph Thomas Dinges | Dentist | 7124 S Outer 364, O Fallon, MO 63368-7756 | 2020-08-18 |
| 1104279751 | Melissa King | Dentist | 3009 Winghaven Blvd, O Fallon, MO 63368-3600 | 2016-07-19 |
| 1639528540 | Kyle James Neuschaefer | Dentist | 31 Ofallon Sq, O Fallon, MO 63366 | 2016-06-10 |
| 1417395674 | Alan Marshall Johnson | Dentist | 126 Triad Ctr W, O Fallon, MO 63366-7541 | 2013-06-10 |
| 1831472414 | Travis C Schwarz | Dentist | 8618 Mexico Rd, Suite 320, O Fallon, MO 63366-7507 | 2011-09-21 |
| 1881982833 | Ashutosh Shrivastava | Dentist | 3009 Highway K, O Fallon, MO 63368-8696 | 2011-07-12 |
| 1932336799 | Jeffrey Justin Harris | Dentist | 1630 Market Center Dr, Suite 100, O Fallon, MO 63368-8407 | 2009-06-18 |
| 1659508968 | Brian Paul Spence | Dentist | 2315 Technology Dr Ste 101, O Fallon, MO 63368-7371 | 2009-06-12 |
| 1376716548 | Sarah Christina Northcott | Dentist | 2934 Highway K, O Fallon, MO 63368-7861 | 2008-04-09 |
| 1932237856 | Gregory Biddulph | Dentist | 1490 N Green Mount Rd, Suite B, O Fallon, IL 62269-3416 | 2007-03-01 |
| Find all providers in O FALLON | ||||
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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.