Healthcare Provider Details

I. General information

NPI: 1902199417
Provider Name (Legal Business Name): MEGAN ELIZABETH LENAHAN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2011
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5637 TELEGRAPH RD
SAINT LOUIS MO
63129-4219
US

IV. Provider business mailing address

5637 TELEGRAPH RD
SAINT LOUIS MO
63129-4219
US

V. Phone/Fax

Practice location:
  • Phone: 314-843-8500
  • Fax: 314-843-9449
Mailing address:
  • Phone: 314-843-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number2011015039
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2011015039
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: