New Creation Dental Care LC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2003013106 Issued in MO

Legal business name

NEW CREATION DENTAL CARE LC

Practice address

15 Lakeside Dr Ste a
Lake St Louis, MO 63367-1378

Phone

(636) 625-1225

NPI assigned

Apr 12, 2007

Last updated

Jan 16, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Matthew Boscia, D.M.D.NPI 1043540552

Title

President

Phone

(636) 625-1225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew James Boscia, D.M.D

  • General Practice Dentistry
  • Lake St Louis, MO
  • NPI 1043540552
  Authorized official Same address or phone
• Salim Mistrih, DMD

  • Dentist
  • Rolla, MO
  • NPI 1972345700
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768521600000",
    "number": "1801010467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LAKESIDE DR STE A",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671378",
            "telephone_number": "636-625-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 LAKESIDE DR STE A",
            "city": "LAKE ST LOUIS",
            "state": "MO",
            "postal_code": "633671378",
            "telephone_number": "636-625-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CREATION DENTAL CARE LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A",
        "authorized_official_last_name": "BOSCIA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-625-1225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2003013106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Calvin Neill Jr.
• Neuage LSL LLC
• Kimberly Neustadt
• New Balance Lake St. Louis
• New Creation Center for Dental Sleep Medicine LLC
• New Journey Christian Counseling LLC
• David A. Nickel, M.D.
• Northstar Health Group LLC
• John Joseph O'Connell IV
• Stephanie Lynne Ohmes, RN

• General Practice Dentistry in Lake St Louis, MO
• Providers in Lake St Louis, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.