Smile Brilliant Ventures

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

Legal business name

SMILE BRILLIANT VENTURES

Practice address

1645 Headland Dr
Fenton, MO 63026-2836

Phone

(855) 944-8361

NPI assigned

Oct 2, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Michael Bluestone

Title

Business Owner

Phone

(314) 409-3598

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1023836673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 HEADLAND DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262836",
            "telephone_number": "855-944-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 HEADLAND DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262836",
            "telephone_number": "855-944-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE BRILLIANT VENTURES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "BLUESTONE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "314-409-3598",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Signature Medical Group, Inc.
• Anthony John Sindel, PHARM.D.
• Lori Sindel, OTR/L, FNP-BC
• Katharyn Skowyra, OTD, OTR/L
• Stephen Slowik, DO
• Chad Smith, D.C., M.S.
• Jennifer Noble Smith, MSPT, OCS
• Stacia Smith, FNP
• Barbara Ann Snyder, PT
• Donna Sue Snyder, RN

• Dental Laboratory in Fenton, MO
• Providers in Fenton, MO by specialty
• Dental Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.