Active NPI
Salim Mistrih, DMD
- Dentist
- Rolla, MO
National Provider Identifier
1972345700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2024021561
- Practice address
- 1701 E 10TH St
Rolla, MO 65401-4601 - Phone
- (573) 364-1599
- NPI assigned
- Jun 11, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2024021561 | MO | Primary |
Addresses
Primary practice location
1701 E 10TH St
Rolla, MO 65401-4601
Mailing address
1701 E 10TH St
Rolla, MO 65401-4601
Phone (573) 364-1599
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024021561 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Creation Center for Dental Sleep Medicine LLC | Past | Accepting new patients | |
| New Creation Dental Care LC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Lake St Louis, MO
- NPI 1972963460
-
- General Practice Dentistry
- Lake St Louis, MO
- NPI 1801010467
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1972345700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1701 E 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654014601",
"telephone_number": "573-364-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 E 10TH ST",
"city": "ROLLA",
"state": "MO",
"postal_code": "654014601",
"telephone_number": "573-364-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTRIH",
"first_name": "SALIM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-11",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2024021561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolla, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.