DR. LARRY L BORTH (NPI# 1982732541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982732541 |
| Entity Type | Individual |
| Full Name | DR. LARRY L BORTH |
| Credential | DDS |
| Practice Address |
3394 Mckelvey Rd Suite 104 Bridgeton MO 63044-2531 |
| Practice Telephone | 3147394412 |
| Practice Fax Number | 3147394748 |
| Mailing Telephone | 3147394412 |
| Mailing Fax Number | 3147394748 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
012184 | MO | Dental Providers |
| Street Address |
3394 MCKELVEY RD SUITE 104 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629077110 | Glenna Carolyn Franke | General Practice | 3394 Mckelvey Rd, Ste 113, Bridgeton, MO 63044-2531 | 2005-07-18 |
| 1881079994 | Arch Bariatrics LLC | Surgery | 3394 Mckelvey Rd, Suite 115, Bridgeton, MO 63044-2531 | 2015-07-30 |
| 1275888471 | Renewing Minds, LLC | Counselor | 3394 Mckelvey Rd, Suite 116, Bridgeton, MO 63044-2531 | 2012-07-13 |
| 1407189871 | Michael King | Counselor | 3394 Mckelvey Rd, 116, Bridgeton, MO 63044-2531 | 2009-09-16 |
| 1598926917 | Saint Louis Health Services LLC | Family Medicine | 3394 Mckelvey Rd, Suite 104, Bridgeton, MO 63044-2531 | 2008-06-18 |
| 1942484225 | Metro Internal Medicine LLC | Internal Medicine | 3394 Mckelvey Rd, Suite 106, Bridgeton, MO 63044-2531 | 2007-12-23 |
| 1508062316 | G. C. Franke, D.o., Inc. | Family Medicine | 3394 Mckelvey Rd, Suite 113, Bridgeton, MO 63044-2531 | 2007-06-27 |
| 1407980931 | St. Louis General Surgery, PC | Surgery | 3394 Mckelvey Rd, Suite 115, Bridgeton, MO 63044-2531 | 2007-03-15 |
| 1740330133 | Gerard William Boehmer | Chiropractor | 3394 Mckelvey Rd, Suite 108, Bridgeton, MO 63044-2531 | 2007-01-10 |
| 1003978065 | Lisa Cathleen Briz | Social Worker | 3394 Mckelvey Rd, Bridgeton, MO 63044-2531 | 2006-12-15 |
| 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 | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558578187 | Terry Egan Dds LLC | Dentist | 12758 Boenker Ln, Bridgeton, MO 63044-2436 | 2007-05-16 |
| 1649395393 | Terry R Egan | Dentist | 12758 Boenker Ln, Bridgeton, MO 63044-2436 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609233089 | Seth Rush, D.d.s., M.s., L.L.C. | Dentist | 9233 Ward Pkwy Ste 330, Kansas City, MO 64114-3310 | 2016-01-15 |
| 1861877227 | Pierluigi Balice | Dentist | 650 E 25th St # 277, Kansas City, MO 64108-2716 | 2015-07-28 |
| 1881960102 | Sara Layne Walls | Dentist | 833 Sw Lemans Ln Ste 234, Lees Summit, MO 64082-4618 | 2012-03-30 |
| 1376814723 | Nabil Beaini | Dentist | 201 W Broadway Ste 5a, Columbia, MO 65203-3842 | 2012-01-17 |
| 1639494214 | Daniel J Thomas, Dds Periodontal Specialists, PC | Dentist | 3355 Ne Ralph Powell Rd, Lees Summit, MO 64064-2368 | 2010-04-07 |
| 1679804157 | John C Hoppin, Dds., PC | Dentist | 1 Westbury Dr Ste 300, Saint Charles, MO 63301-2560 | 2010-01-22 |
| 1750537320 | Robert R. Schlueter Dmd PC | Dentist | 9914 Kennerly Rd., St. Louis, MO 63128-2704 | 2008-08-14 |
| 1972785533 | Amy Leigh Gillihan | Dentist | 3151 S 291 Hwy, Suite B, Independence, MO 64057-2602 | 2007-12-05 |
| 1750590139 | Humaira Y Habib | Dentist | 420 S Pearl Ave, Ste 4, Joplin, MO 64801-2541 | 2007-05-22 |
| 1225240856 | Videsh Damodar Deshmukh | Dentist | 300 Chesterfield Ctr, Siute # 160, Chesterfield, MO 63017-4867 | 2007-05-04 |
| 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.