Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Creve Coeur Periodontics, Inc

Organization Periodontics · NPI 1174799415

Creve Coeur Periodontics, Inc provides Periodontics in Creve Coeur, Missouri. Licensed in Missouri. Registered with an NPI since 2008.

Licensed in
MO
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11709 Old Ballas Rd Ste 206
Creve Coeur, MO 63141-7029 Not confirmed with CMS for 18 years — call before visiting
Phone: (314) 567-3760
Fax: (314) 567-3929
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence 14247 (MO)

Record details

NPI number1174799415
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Marwan Assaf — Owner · (314) 567-3760
NPI enumeratedMay 6, 2008
Last updated in NPPESMay 6, 2008
Mailing address11709 Old Ballas Rd, Suite 206, Creve Coeur, MO 63141-7029

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