Healthcare Provider Details

I. General information

NPI: 1225974264
Provider Name (Legal Business Name): CELEBRATE EMERGENCY DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7934 N LINDBERGH BLVD
HAZELWOOD MO
63042-3521
US

IV. Provider business mailing address

7934 N LINDBERGH BLVD
HAZELWOOD MO
63042-3521
US

V. Phone/Fax

Practice location:
  • Phone: 816-558-9890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: PATRICK CAMPBELL
Title or Position: DENTIST/OWNER
Credential: DMD
Phone: 937-838-5128