New Creation Center for Dental Sleep Medicine LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2003013106 Issued in MO

Legal business name

NEW CREATION CENTER FOR DENTAL SLEEP MEDICINE LLC

Practice address

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

Phone

(636) 625-1225

Fax

(636) 625-1228

NPI assigned

Feb 26, 2016

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

Title

Dentist

Phone

(636) 625-1225

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• 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": "1456444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1972963460",
    "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",
            "fax_number": "636-625-1228"
        },
        {
            "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",
            "fax_number": "636-625-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW CREATION CENTER FOR DENTAL SLEEP MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "BOSCIA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "636-625-1225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2003013106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ammar Nasir, MD
• Michael Calvin Neill Jr.
• Neuage LSL LLC
• Kimberly Neustadt
• New Balance Lake St. Louis
• New Creation Dental Care LC
• New Journey Christian Counseling LLC
• David A. Nickel, M.D.
• Northstar Health Group LLC
• John Joseph O'Connell IV

• All providers in Lake St Louis, MO
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.