MEDICARE: DANNY M GENNAOUI DMD LLC

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	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1518214782	OTHER		NPI TYPE 1

General Provider Information

NPI Number	:	1417612904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANNY M GENNAOUI DMD LLC

Provider Business Mailing Address
First Line	:	3701 S LINDBERGH BLVD STE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1372
Country	:	US
Telephone Number	:	314-821-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 S LINDBERGH BLVD STE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63127-1372
Country	:	US
Telephone Number	:	314-821-4410
Fax Number	:

Authorized Official
Title or Position	:	TREATMENT COORDINATOR
Name	:	TARA REES
Credential	:
Telephone Number	:	314-821-4410

Provider Enumeration Date	:	11/01/2021
Last Update Date	:	11/01/2021

Similar Medicare Providers

1801845698 — HEIDI STRICKLER LCSW
Practice Location Address:

3701 S LINDBERGH BLVD STE 205
SAINT LOUIS, MO
63127-1372

Practice Phone: 314-526-1565
Practice Fax:

1245397256 — MS. KATHRYN GAIL ELLIS MSW
Practice Location Address:

3701 S LINDBERGH BLVD STE 205
SAINT LOUIS, MO
63127-1372

Practice Phone: 314-965-1942
Practice Fax: 314-835-1580

1568765808 — MS. TAMMY SUE COOK RD
Practice Location Address:

3701 S LINDBERGH BLVD STE 205
SAINT LOUIS, MO
63127-1372

Practice Phone: 314-616-2526
Practice Fax:

1518214782 — DANNY GENNAOUI DMD
Practice Location Address:

3701 S LINDBERGH BLVD STE 200
SAINT LOUIS, MO
63127-1372

Practice Phone: 314-821-4410
Practice Fax:

1942329263 — KINCAID MEDICAL ASSOCIATES PC
Practice Location Address:

3016 LOCUST ST , SUITE 104
SAINT LOUIS, MO
63103-1372

Practice Phone: 314-531-0008
Practice Fax: 314-531-0145

1861449605 — VILLAGE OF MAYWOOD
Practice Location Address:

700 SAINT CHARLES RD
MAYWOOD, IL
60153-1372

Practice Phone: 708-343-5595
Practice Fax: 708-681-8840

Directions to “DANNY M GENNAOUI DMD LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.