Imagine Smiles PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

IMAGINE SMILES PLLC

Practice address

13205 Reams Rd Unit 164
Windermere, FL 34786

Phone

(864) 906-6179

NPI assigned

Apr 15, 2021

Organization subpart

No

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

Authorized official

Name

Thao Latham, DMD

Title

Owner

Phone

(864) 906-6179

Specialties & licenses 2

Addresses

Other names 1

• Parkview Kids Dental & Orthodontics Doing business as

Locations

Practitioners 1

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

• Thao Trang Ngoc Latham, DMD

  • Dentist
  • Cameron, SC
  • NPI 1598171555
  NPD

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618444800000",
    "number": "1013598739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5259 ARIVA DR APT 101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124436",
            "telephone_number": "864-906-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13205 REAMS RD UNIT 164",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "34786",
            "telephone_number": "864-906-6179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "LATHAM",
        "authorized_official_first_name": "THAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-906-6179",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkview Kids Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lashae E Humphrey, MSN, APRN, PMHNP-BC
• Matthew David Hurbanis, M.D.
• Hyma General Services LLC
• Hyma General Services LLC
• Hyperflow Medical, LLC
• Inpatient Hospital Neurologists PA
• Inspired Dental PA
• Institute of Behavioral Medicine PLLC
• Lori H Isaacs-Hoar, ARNP
• Elguine Vendriss Isidor, RN

• Pediatric Dentistry in Windermere, FL
• Providers in Windermere, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.