PROVIDE DENTAL NPI 1952292005

NPI Information

  • NPI: 1952292005
  • Provider Name: PROVIDE DENTAL
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 14377 WOODLAKE DR STE 205
    CHESTERFIELD, MO
    ZIP 63017
  • Phone: (314) 576-0088

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NPI Details

PROVIDE DENTAL is a dental clinic center in Chesterfield, MO. PROVIDE DENTAL NPI is 1952292005. The provider is registered as an organization entity type.

The provider's business location address is:

14377 WOODLAKE DR STE 205
CHESTERFIELD, MO
ZIP 63017-735
Phone: (314) 576-0088

The provider's authorized official is Philip Son .
The authorized official title is Owner/ General Dentist and has the following contact phone number (323) 787-9397.

The enumeration date for this NPI number is 7/15/2025 and was last updated on 7/15/2025.

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
1261QD0000XClinic/CenterDentalYes

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

NPI Synchronization or Removal

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