Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northside Dental LLC

Organization Dental Clinic/Center · NPI 1922401793

Northside Dental LLC is a Dental Clinic/Center in Springfield, Missouri. Licensed in Missouri. Registered with an NPI since 2014.

Licensed in
MO
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2105 W Kearney St Ste A
Springfield, MO 65803-1652
Phone: (417) 862-2468
Fax: (417) 863-6775
Show map & directions

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

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence 2003017125 (MO)

Record details

NPI number1922401793
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derek Dds — Owner/Dentist · (417) 862-2468
Other names Northside Dental Clinic
NPI enumeratedOctober 7, 2014
Last updated in NPPESOctober 7, 2014
Mailing address2105 W Kearney St, Suite A, Springfield, MO 65803-1652

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