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MIDWEST MOBILE DENTISTRY LLC
NPI 1417477985
Clinic/Center - Dental in Saint Louis, MO

Active since June 26, 2017
1 N BRENTWOOD BLVD STE 1000, SAINT LOUIS, MO 63105(225) 287-8765(615) 225-8915 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jun 26, 2017 (2 updates tracked since 2017).

About Midwest Mobile Dentistry Llc NPPES

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

MIDWEST MOBILE DENTISTRY LLC (NPI 1417477985) is a healthcare organization registered as a dental in Saint Louis, Missouri and active in the NPI registry since June 2017. The organization lists Jeremy Gordon Graham, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1417477985
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMIDWEST MOBILE DENTISTRY LLC
Location Address1 N BRENTWOOD BLVD STE 1000Saint Louis, MO 63105-3937
Mailing Address1 North Brentwood Boulevard, Suite 1000St Louis, MO 63105 · (225) 287-8765 · Fax (615) 225-8915
Phone(225) 287-8765
Fax(615) 225-8915
Organization SubpartNo
Authorized OfficialJeremy Gordon GrahamOwner/ceo · (225) 287-8765
Enumeration DateJune 26, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1417477985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1 N BRENTWOOD BLVD STE 1000, Saint Louis, MO 63105
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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 Midwest Mobile Dentistry LLC's NPI number?

The NPI number for Midwest Mobile Dentistry LLC is 1417477985. It was assigned to this organization in the NPPES registry on June 26, 2017.

Where is Midwest Mobile Dentistry LLC located?

Midwest Mobile Dentistry LLC is located at 1 N Brentwood Blvd Ste 1000, Saint Louis, MO 63105. The listed phone number is (225) 287-8765.

What is Midwest Mobile Dentistry LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Midwest Mobile Dentistry LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.