NUMPOL DEJTIRANUKUL DMD LLC NPI 1043479215

NPI Information

  • NPI: 1043479215
  • Provider Name: NUMPOL DEJTIRANUKUL DMD LLC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 4122 KEATON CROSSING BLVD
    SUITE 101
    O FALLON, MO
    ZIP 63368
  • Phone: (636) 300-4280

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NPI Details

NUMPOL DEJTIRANUKUL DMD LLC is a general practice dentist in O Fallon, MO. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. NUMPOL DEJTIRANUKUL DMD LLC NPI is 1043479215. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4122 KEATON CROSSING BLVD
SUITE 101
O FALLON, MO
ZIP 63368-218
Phone: (636) 300-4280

The provider's authorized official is Numpol Dejtiranukul .
The authorized official title is Single Member and has the following contact phone number (636) 300-4280.

The enumeration date for this NPI number is 6/3/2008 and was last updated on 6/3/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2000170243MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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