Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack W. Haney, DDS, PC

Organization Dentist · NPI 1124598594

Jack W. Haney, DDS, PC is a Dentist in Saint Louis, Missouri. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4527 Forest Park Ave
Saint Louis, MO 63108-2113
Phone: (314) 367-7200
Fax: (314) 367-0508
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X
Dentist Taxonomy 122300000X

Record details

NPI number1124598594
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ty Justice — Director, Payer Relations · (513) 808-4984
Other names Forest Park Dental
NPI enumeratedNovember 28, 2018
Last updated in NPPESNovember 28, 2018
Mailing address9825 Kenwood Rd Ste 200, Blue Ash, OH 45242-6252

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