Smile Galaxy Pediatric Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5436 Issued in OK

Legal business name

SMILE GALAXY PEDIATRIC DENTISTRY

Practice address

9801 S. Pennsylvania
Oklahoma City, OK 73159-6925

Phone

(405) 692-1222

Fax

(405) 703-0930

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert Brian Molloy, D.D.S.

Title

Business Owner

Phone

(405) 692-1222

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Smile Zone Pediatric Dentistry Former legal business name

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1023034451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 892290",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731892290",
            "telephone_number": "405-692-1222",
            "fax_number": "405-703-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 S. PENNSYLVANIA",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596925",
            "telephone_number": "405-692-1222",
            "fax_number": "405-703-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE GALAXY PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "MOLLOY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "405-692-1222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OK",
            "license": "5436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200066610A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1390128",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Zone Pediatric Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Taylor Rene' Smedley
• Donna D. Smela, LCSW
• Stacee Deanne Smiddy, APRN-CNP, IBCLC
• Smile a While Pediatric Therapy PLLC
• Smile Galaxy Orthodontics
• Smile Studio of Claremore LLC
• Smilestones ABA Ok LLC
• Amani Smiley
• Bentlee B Smiley
• Constance A. Smiley, M.D.

• Dental Clinic/Center in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Dental Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.