OrganizationActive
Southeast Missouri Health Network
NPI 1679019491 · Dentist · East Prairie, MO
Provider details
- NPI number
- 1679019491
- Entity type
- Organization
- Primary specialty
- DentistDental Providers
- Parent organization
- Southeast Missouri Health Network
- Organization subpart
- Yes
- Authorized official
- Sara Deane, Cfo(573) 313-2500
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
111 Prairie Drive
East Prairie, MO 63845
Phone: (573) 649-9311
Fax: (573) 649-9331
Street-level locationGet directions
Mailing address
111 Prairie Drive
East Prairie, MO 63845
Additional practice locations (1)
- 111 Prairie DrSte a & BEast Prairie, MO 63845-1114Phone: (573) 649-9311Fax: (573) 649-9331
Registry dates
- Enumerated
- 2017-01-18
- Last updated
- 2017-11-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.