Smile 90210 LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34503 Issued in MA

Legal business name

SMILE 90210 LLC

Practice address

416 N Bedford Dr
Suite 102
Beverly Hills, CA 90210-4322

Phone

(310) 273-6637

Fax

(310) 273-2138

NPI assigned

Jul 3, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Tom KaliliNPI 1063671758

Title

Dentist/Owner

Phone

(310) 273-6637

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tom Kalili, D.M.D

  • General Practice Dentistry
  • Beverly Hills, CA
  • NPI 1063671758
  NPD (past) Authorized official

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1013271105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-273-6637",
            "fax_number": "310-273-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 N BEDFORD DR",
            "address_2": "SUITE 102",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104322",
            "telephone_number": "310-273-6637",
            "fax_number": "310-273-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE 90210 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "KALILI",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "310-273-6637",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "34503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SM Ortho LLC
• Small Talk Speech and Language Therapy, Inc
• Small World Med Corporation
• Stephanie Beth Small
• Trevor Z Small, PSY.D.
• Smile Angels of Beverly Hills
• Susan Elizabeth Smiley, MED
• Tarick Kamal Smiley, M.D.
• Darrel J Smith, PSY.D.
• Katherine Wilson Smith, PSYD

• General Practice Dentistry in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.