NEW CREATION DENTAL CARE LC – General Practice Dentistry, NPI 1801010467

NEW CREATION DENTAL CARE LC is a healthcare provider. based in Lake st louis, Missouri. specializing in General Practice Dentistry. The organization holds a License No. 2003013106 (MO). The NPI Number for NEW CREATION DENTAL CARE LC is 1801010467

Main info

Organization
Name
NEW CREATION DENTAL CARE LC
NPI
1801010467
Phone
(636) 625-1225
Address
15 LAKESIDE DR
Authorized Official
DR. MATTHEW BOSCIA PRESIDENT D.M.D.
Enumeration Date
12 April 2007
Last Update Date
16 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for NEW CREATION DENTAL CARE LC

  • 15 LAKESIDE DR

    LAKE ST LOUIS, MO 633671378

    Phone: (636) 625-1225

    Type: Mailing

  • 15 LAKESIDE DR STE A

    LAKE ST LOUIS, MO 633671378

    Phone: (636) 625-1225

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2026-02-17

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20260217000820OOral Surgery - DentistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63367)

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Reviews

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Frequently asked questions

What unique ID ties claims to NEW CREATION DENTAL CARE LC?
NPI 1801010467 is assigned to NEW CREATION DENTAL CARE LC under the national enumeration system.
Is NEW CREATION DENTAL CARE LC currently active in the NPI registry?
CMS-published data lists NEW CREATION DENTAL CARE LC as an active registrant.
What kind of provider is NEW CREATION DENTAL CARE LC?
The page reflects General Practice Dentistry for NEW CREATION DENTAL CARE LC. Clinical services aligned with this taxonomy classification.
Where does public data place NEW CREATION DENTAL CARE LC?
The snapshot lists Lake St Louis, Missouri for NEW CREATION DENTAL CARE LC; download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Organization.

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