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BRENTWOOD DENTAL GROUP
NPI 1548321318
Dentist - General Practice in Saint Louis, MO

Active since December 13, 2006
2440 S BRENTWOOD BLVD, SAINT LOUIS, MO 63144(314) 962-6643(314) 962-2205 Get Directions Write a Review

NPPES record last updated: August 21, 2007. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Brentwood Dental Group NPPES

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

BRENTWOOD DENTAL GROUP (NPI 1548321318) is a healthcare organization registered as a general practice in Saint Louis, Missouri and active in the NPI registry since December 2006. The organization lists Michael J. Faddis, Owner, as its authorized official.

NPPES Registry Identity

NPI1548321318
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCHARLES E. NIESEN II, DMD, MICHAEL J. FADDIS, DDS
Location Address2440 S BRENTWOOD BLVDSaint Louis, MO 63144-2321
Mailing Address2440 S Brentwood BlvdSaint Louis, MO 63144-2321 · (314) 962-6643 · Fax (314) 962-2205
Phone(314) 962-6643
Fax(314) 962-2205
Organization SubpartNo
Authorized OfficialMichael J. FaddisOwner · (314) 962-6643
Enumeration DateDecember 13, 2006
Last NPPES UpdateAugust 21, 2007
✔ NPI 1548321318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
2440 S BRENTWOOD BLVD, Saint Louis, MO 63144
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Other Names 1

Doing Business AsBrentwood Dental Group

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

Other Providers at the Same Location NPPES 5

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

DR. MICHAEL FADDIS DDS
Dentist (General Practice)
2440 S BRENTWOOD BLVD
SAINT LOUIS, MO 63144
St. Louis County (314) 962-6643
SETH WASSON DMD
Dentist (General Practice)
2440 S BRENTWOOD BLVD
SAINT LOUIS, MO 63144
St. Louis County (314) 962-6643
DR. CHARLES EDWARD NIESEN II DMD
Dentist (General Practice)
2440 S BRENTWOOD BLVD
SAINT LOUIS, MO 63144
St. Louis County (314) 962-6643
DR. BRENTON PATRICK RUOPP DDS
Dentist
2440 S BRENTWOOD BLVD
BRENTWOOD, MO 63144
St. Louis County (314) 696-1544
KENNETH NEAL BROSH DDS
Dentist
2440 S BRENTWOOD BLVD
BRENTWOOD, MO 63144
St. Louis County (314) 962-6643

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 Charles E. Niesen II, Dmd, Michael J. Faddis, Dds's NPI number?

The NPI number for Charles E. Niesen II, Dmd, Michael J. Faddis, Dds is 1548321318. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is doing business as Brentwood Dental Group.

Where is Charles E. Niesen II, Dmd, Michael J. Faddis, Dds located?

Charles E. Niesen II, Dmd, Michael J. Faddis, Dds is located at 2440 S Brentwood Blvd, Saint Louis, MO 63144. The listed phone number is (314) 962-6643.

What is Charles E. Niesen II, Dmd, Michael J. Faddis, Dds's specialty?

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

When was this NPI record last updated?

The NPPES record for Charles E. Niesen II, Dmd, Michael J. Faddis, Dds was last updated on August 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.