OrganizationActive
Copper Creek LLC
NPI 1104319862 · Dental Clinic/Center · Ozark, MO
Provider details
- NPI number
- 1104319862
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jonathan Jacoby, Dentist(816) 863-7096
- License
- 2015016758 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
797 W South St
Ozark, MO 65721-9261
Phone: (417) 581-0835
Street-level locationGet directions
Mailing address
119 Jared Blvd
Webb City, MO 64870-9214
Other names (DBA / former)
- Other name
- Copper Creek Dental
Registry dates
- Enumerated
- 2018-06-07
- Last updated
- 2018-06-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.