OrganizationActive
Northside Dental L.L.C.
NPI 1922401793 · Dental Clinic/Center · Springfield, MO
Northside Dental L.L.C. is a Dental Clinic/Center organization in Springfield, MO (NPI 1922401793).
Provider details
- NPI number
- 1922401793
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Derek DDS, Owner/Dentist(417) 862-2468
- License
- 2003017125 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
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
11 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
2105 W Kearney St
Suite a
Springfield, MO 65803-1652
Phone: (417) 862-2468
Fax: (417) 863-6775
Street-level locationGet directions
Mailing address
2105 W Kearney St
Springfield, MO 65803-1652
Other names (DBA / former)
- Doing business as
- Northside Dental Clinic
Registry dates
- Enumerated
- 2014-10-07
- Last updated
- 2014-10-07
Frequently asked questions
- What is Northside Dental L.L.C.'s NPI number?
- Northside Dental L.L.C.'s National Provider Identifier (NPI) is 1922401793, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Northside Dental L.L.C.?
- Northside Dental L.L.C. is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Northside Dental L.L.C. located?
- Northside Dental L.L.C.'s practice location on file with NPPES is 2105 W Kearney St, Springfield, MO 65803-1652.
- What is Northside Dental L.L.C.'s phone number?
- The practice phone number listed in the NPPES registry for Northside Dental L.L.C. is (417) 862-2468.
- Who is the authorized official for Northside Dental L.L.C.?
- The authorized official listed on Northside Dental L.L.C.'s NPPES record is Derek DDS, Owner/Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Northside Dental L.L.C.'s NPI active?
- Yes — Northside Dental L.L.C.'s NPI (1922401793) is active in the NPPES registry as of the last update on 2014-10-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.