Provider Demographics
NPI:1225115355
Name:DENNIS P DONE DMD PC
Entity Type:Organization
Organization Name:DENNIS P DONE DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:DONE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-965-7220
Mailing Address - Street 1:128 EAST JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-4026
Mailing Address - Country:US
Mailing Address - Phone:314-965-7220
Mailing Address - Fax:
Practice Address - Street 1:128 EAST JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-4026
Practice Address - Country:US
Practice Address - Phone:314-965-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODEN0145921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
101618OtherBC BS FEDERAL