Copper Creek LLC
Copper Creek LLC is a healthcare organization registered as Dental Clinic/Center in Ozark, MO, holding Type 2 (organization) NPI 1104319862 since 2018. The authorized official on file is Jonathan Jacoby, Dentist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104319862 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Copper Creek LLC |
| Other name | <Unavail> |
| Practice address | 797 W SOUTH ST, Ozark, MO, 65721 |
| Phone | 4175810835 |
| Enumeration date | 2018-06-07 |
| Last updated in NPPES | 2018-06-07 |
Authorized official
| Name | Jonathan Jacoby |
|---|---|
| Title | Dentist |
| Phone | 8168637096 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 261QD0000X | Dental Clinic/Center | Primary | 2015016758 | MO |
Copy-ready billing details
Provider: Copper Creek LLC NPI: 1104319862 Taxonomy: 261QD0000X (Dental Clinic/Center) Address: 797 W SOUTH ST, Ozark, MO, 65721
Verify this record
Cross-check NPI 1104319862 against the authoritative CMS record: view Copper Creek LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Copper Creek LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2018-06-07.