Healthcare Provider Details

I. General information

NPI: 1679485031
Provider Name (Legal Business Name): LITTLE SMILES OF SHRESWBURY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 WATSON RD
SAINT LOUIS MO
63119-4404
US

IV. Provider business mailing address

1709 HERITAGE HILLS DR
WASHINGTON MO
63090-4621
US

V. Phone/Fax

Practice location:
  • Phone: 636-238-3520
  • Fax:
Mailing address:
  • Phone: 636-238-3520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. COREY HASTINGS
Title or Position: OWNER
Credential: DDS
Phone: 636-238-3520