Smile Dental Centralia LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE DENTAL CENTRALIA LLC

Practice address

110 W Sneed St
Centralia, MO 65240-1375

Phone

(573) 682-5616

NPI assigned

Oct 23, 2017

Last updated

Oct 23, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie Sue Powell

Title

Office Manager

Phone

(660) 263-6642

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1033620570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "MOBERLY",
            "state": "MO",
            "postal_code": "652700306",
            "telephone_number": "660-263-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SNEED ST",
            "city": "CENTRALIA",
            "state": "MO",
            "postal_code": "652401375",
            "telephone_number": "573-682-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DENTAL CENTRALIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-263-6642"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica B Reynolds, MS CCC SLP
• Deanna D Richman
• Emily M Riddle, M.ED, PLPC
• Anna Romine, MD
• Tayler Scholes
• Rhonda K Smith
• Shauna Starks, OTR/L
• Greg Taylor Swartz, DDS
• Tailored Made Hair Replacement Center LLC (Tailored Made Hair)
• Tom Elsbury Insurance Agency LLC

• General Practice Dentistry in Centralia, MO
• Providers in Centralia, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.