OrganizationActive
Creve Coeur Periodontics, Inc.
NPI 1174799415 · Periodontics · Creve Coeur, MO
Provider details
- NPI number
- 1174799415
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Organization subpart
- No
- Authorized official
- Marwan Assaf, Owner(314) 567-3760
- License
- 14247 (MO)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
11709 Old Ballas Rd
Suite 206
Creve Coeur, MO 63141-7029
Phone: (314) 567-3760
Fax: (314) 567-3929
Street-level locationGet directions
Mailing address
11709 Old Ballas Rd
Creve Coeur, MO 63141-7029
Registry dates
- Enumerated
- 2008-05-06
- Last updated
- 2008-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.