COURTNEY ETHINGTON DMD MSD NPI 1134767866

NPI Information

NPI: 1134767866
Provider Name: COURTNEY ETHINGTON, DMD, MSD
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

Address:
4 WEST DR STE 170
CHESTERFIELD, MO
ZIP 63017
Phone: (636) 778-9345
Get Directions

Courtney Ethington, DMD, MSD is an oral and maxillofacial surgery dentist in Chesterfield, MO. The provider is an oral and maxillofacial surgery dentist specialized in 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. Courtney Ethington, DMD, MSD NPI is 1134767866. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4 WEST DR STE 170
CHESTERFIELD, MO
ZIP 63017-793
Phone: (636) 778-9345

The enumeration date for this NPI number is 12/12/2019 and was last updated on 12/12/2019.

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
1	1223S0112X	Dentist	Oral and Maxillofacial Surgery	2019043361	MISSOURI	Yes
2	1223X0400X	Dentist	Orthodontics and Dentofacial Orthopedics	019.032433	ILLINOIS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2019043361	OTHER	MISSOURI	MISSOURI DENTAL LICENSE
2	019.032433	OTHER	ILLINOIS	ILLINOIS DENTAL LICENSE

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: 4/28/2024

NPI Synchronization or Removal

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