OrganizationActive
South County Dental Imaging Center
NPI 1053647008 · Radiology Clinic/Center · Saint Louis, MO
Provider details
- NPI number
- 1053647008
- Entity type
- Organization
- Primary specialty
- Radiology Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- John Monterubio, President(314) 721-1010
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12818 Tesson Ferry Rd
Suite 204
Saint Louis, MO 63128-2945
Phone: (314) 722-2033
Fax: (314) 842-1590
Street-level locationGet directions
Mailing address
1034 S Brentwood Blvd
Saint Louis, MO 63117-1223
Registry dates
- Enumerated
- 2009-10-27
- Last updated
- 2009-10-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.