Signature Smile

Primary specialty

DentistTaxonomy code 122300000X

License

3465 Issued in AL

Legal business name

SIGNATURE SMILE

Practice address

2247 Helton Dr
Florence, AL 35630-1035

Phone

(256) 767-6453

Fax

(256) 764-5370

NPI assigned

Jun 5, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sadricia Wilson

Title

Office

Phone

(256) 767-6453

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370390400000",
    "number": "1003254723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2247 HELTON DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301035",
            "telephone_number": "256-767-6453",
            "fax_number": "256-764-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2247 HELTON DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301035",
            "telephone_number": "256-767-6453",
            "fax_number": "256-764-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE SMILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2013-06-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SADRICIA",
        "authorized_official_title_or_position": "OFFICE",
        "authorized_official_telephone_number": "256-767-6453",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "AL",
            "license": "3465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.