MEDICARE: DENNIS P DONE DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DEN014592	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101618	OTHER		BC BS FEDERAL

General Provider Information

NPI Number	:	1225115355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS P DONE DMD PC

Provider Business Mailing Address
First Line	:	128 EAST JEFFERSON AVE
Second Line	:
City	:	ST LOUIS
State	:	MO
Zip	:	63122-4026
Country	:	US
Telephone Number	:	314-965-7220
Fax Number	:

Provider Business Practice Location Address
First Line	:	128 EAST JEFFERSON AVE
Second Line	:
City	:	ST LOUIS
State	:	MO
Zip	:	63122-4026
Country	:	US
Telephone Number	:	314-965-7220
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	DR. DENNIS P DONE
Credential	:	DMD
Telephone Number	:	314-965-7220

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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