Healthcare Provider Details

I. General information

NPI: 1346336179
Provider Name (Legal Business Name): STEVEN MICHAEL HOFFMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 WALSH ST
SAINT LOUIS MO
63109-2859
US

IV. Provider business mailing address

5607 NEOSHO ST
SAINT LOUIS MO
63109-2819
US

V. Phone/Fax

Practice location:
  • Phone: 314-353-0900
  • Fax: 314-353-1018
Mailing address:
  • Phone: 314-353-0900
  • Fax: 314-353-1018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019018444
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2015021495
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: