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Contact Information

ANGELINA ANISIMOVA, DDS
589 MID RIVERS MALL DR
SAINT PETERS, MO63376-2152
 Phone: 636-970-1595
 Fax: 636-279-1117
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for ANGELINA ANISIMOVA · (Female)

NPI Number 1831238096
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 02/05/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2003013493
  • MO Medicaid 408833614
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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