Provider Demographics
NPI:1366548588
Name:WEDDING, JARON RYAH (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:JARON
Middle Name:RYAH
Last Name:WEDDING
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WINNETKA LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3252
Mailing Address - Country:US
Mailing Address - Phone:314-909-9199
Mailing Address - Fax:
Practice Address - Street 1:522 N NEW BALLAS RD
Practice Address - Street 2:SUITE 382
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141-6857
Practice Address - Country:US
Practice Address - Phone:314-994-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050196351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics