Southwest Smiles, LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

5585 Issued in AZ

Legal business name

SOUTHWEST SMILES, LLC

Practice address

2487 S Gilbert Rd Ste 105
Gilbert, AZ 85295-2800

Phone

(480) 732-1888

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Kelly Marie Povar, RDH

Title

Managing Member

Phone

(480) 951-6598

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1013101419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11512 E QUEENSBOROUGH AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852124091",
            "telephone_number": "480-951-6598",
            "fax_number": "480-452-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 S GILBERT RD STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952800",
            "telephone_number": "480-732-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "POVAR",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-951-6598",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "5585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southwest Trans LLC
• Southwest Urologic Specialists, PC
• Southwestern Children'S Health Services, Inc.
• Southwestern Pediatrics PLLC

• Dental Hygienist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Dental Hygienist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.