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COPPER CREEK DENTAL
NPI 1104319862
Clinic/Center - Dental in Ozark, MO

Active since June 07, 2018
797 W SOUTH ST, OZARK, MO 65721(417) 581-0835 Get Directions Write a Review

NPPES record last updated: June 7, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Copper Creek Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COPPER CREEK DENTAL (NPI 1104319862) is a healthcare organization registered as a dental in Ozark, Missouri and active in the NPI registry since June 2018. The organization lists Jonathan W Jacoby, Dentist, as its authorized official.

NPPES Registry Identity

NPI1104319862
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameCOPPER CREEK LLC
Location Address797 W SOUTH STOzark, MO 65721-9261
Mailing Address119 Jared BlvdWebb City, MO 64870-9214 · (816) 863-7096
Phone(417) 581-0835
Organization SubpartNo
Authorized OfficialJonathan W JacobyDentist · (816) 863-7096
Enumeration DateJune 7, 2018
✔ NPI 1104319862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MO · 2015016758
797 W SOUTH ST, Ozark, MO 65721
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Other Names 1

Other NameCopper Creek Dental

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Copper Creek LLC's NPI number?

The NPI number for Copper Creek LLC is 1104319862. It was assigned to this organization in the NPPES registry on June 7, 2018. The provider is also known as Copper Creek Dental.

Where is Copper Creek LLC located?

Copper Creek LLC is located at 797 W South St, Ozark, MO 65721. The listed phone number is (417) 581-0835.

What is Copper Creek LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Copper Creek LLC was last updated on June 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.