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GATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C.
NPI 1184892028
Dentist - Oral and Maxillofacial Surgery in Clayton, MO

Active since February 13, 2008CLIA 26D2057350 · Waiver
165 N. MERAMEC AVE, SUITE 300, CLAYTON, MO 63105(314) 726-2755(314) 726-9538 Get Directions Write a Review

NPPES record last updated: April 11, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 11, 2023, May 13, 2017 (2 updates tracked since 2017).

About Gateway Oral And Maxillofacial Surgeons Of St Louis, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C. (NPI 1184892028), doing business as Travis & Nolen Oral & Maxillofacial Surgery, P.c., is a healthcare organization registered as an oral and maxillofacial surgery in Clayton, Missouri and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through April 14, 2027 and lists Daun M. Brandt, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1184892028
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameGATEWAY ORAL AND MAXILLOFACIAL SURGEONS OF ST LOUIS, P.C.
Location Address165 N. MERAMEC AVE, SUITE 300Clayton, MO 63105-3772
Mailing Address165 N. Meramec Ave, Suite 300Clayton, MO 63105-3772 · (314) 726-2755 · Fax (314) 726-9538
Phone(314) 726-2755
Fax(314) 726-9538
Organization SubpartNo
Authorized OfficialDaun M. BrandtBusiness Manager · (314) 726-2755
Enumeration DateFebruary 13, 2008
Last NPPES UpdateApril 11, 20232 updates tracked since enumeration
NPPES CertifiedApril 11, 2023
✔ NPI 1184892028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MO · 12435
Definition
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.
165 N. MERAMEC AVE, Clayton, MO 63105
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Other Names 1

Former Legal Business NameTravis & Nolen Oral & Maxillofacial Surgery, P.c.

Other Identifiers 1

Other990001492MO · Medicare Group Id

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2057350

Gateway Oral Maxillofacial Surgeons Of St Louis, P C · Clayton, MO
Active · expires Apr 14, 2027
CLIA Number26D2057350
Laboratory TypePhysician Office
Certificate Effective DateApril 15, 2025
Certificate Expiration DateApril 14, 2027
Laboratory DirectorScott F. Nolen
Laboratory Phone(314) 726-2755
Laboratory LocationGateway Oral Maxillofacial Surgeons Of St Louis, P C165 N Meramec, Suite 300, Clayton, MO 63105
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HIRAN R FERNANDO DDS
Dentist (Oral and Maxillofacial Surgery)
165 N. MERAMEC AVE, SUITE 300
CLAYTON, MO 63105
St. Louis County (314) 726-2755
MR. SCOTT F NOLEN DMD
Dentist (Oral and Maxillofacial Surgery)
165 N. MERAMEC AVE, SUITE 300
CLAYTON, MO 63105
St. Louis County (314) 726-2755

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C.'s NPI number?

The NPI number for Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C. is 1184892028. It was assigned to this organization in the NPPES registry on February 13, 2008. The provider was formerly known as Travis & Nolen Oral & Maxillofacial Surgery, P.C..

Where is Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C. located?

Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C. is located at 165 N. Meramec Ave Suite 300, Clayton, MO 63105. The listed phone number is (314) 726-2755.

What is Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Does Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2057350) is associated with this NPI, valid through April 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gateway Oral And Maxillofacial Surgeons Of St Louis, P.C. was last updated on April 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.