KENDRA PHAN DMD
NPI 1477243319
Dentist - General Practice in Warrenton, MO

Q: What is Kendra Phan's NPI number?

The NPI number for Kendra Phan is 1477243319. It was assigned to this individual provider in the NPPES registry on May 12, 2023.

Q: What is Kendra Phan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kendra Phan was last updated on May 29, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 12, 2023PECOS Enrolled

19515 BRUNE PKWY, WARRENTON, MO 63383(844) 853-8937 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 29, 2025, Oct 10, 2023, May 12, 2023 (3 updates tracked since 2023).

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About Kendra Phan Dmd NPPES

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

KENDRA PHAN DMD (NPI 1477243319) is an individual general practice provider in Warrenton, Missouri, licensed in Missouri (2025018921) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1477243319

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameKENDRA PHANCredential: DMD

Location Address19515 BRUNE PKWYWarrenton, MO 63383-6505

Mailing Address1500 Park AveSaint Louis, MO 63104-3024 · (314) 881-8254

Phone(844) 853-8937

Sole ProprietorNo

Enumeration DateMay 12, 2023

Last NPPES UpdateMay 29, 20253 updates tracked since enumeration

NPPES CertifiedMay 29, 2025

✔ NPI 1477243319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MO · 2025018921

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

19515 BRUNE PKWY, Warrenton, MO 63383

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Secondary Practice Location 1

Location 11500 Park AveSaint Louis, MO 63104-3024 · Phone (314) 881-8254

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kendra Phan Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63383 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

DANIELLE MARIE AUBUCHON LCSW

Social Worker (Clinical)