Active NPI
Smiles on Wheels, LLC
- Dental Clinic/Center
- Shreveport, LA
National Provider Identifier
1033910567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- SMILES ON WHEELS, LLC
- Practice address
- 2701 Frederick St
Shreveport, LA 71109-3607 - Phone
- (702) 205-2623
- NPI assigned
- Mar 21, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Evans
- Title
- Ceo/Owner
- Phone
- (702) 205-2623
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Laboratory Technician | 126900000X | |||
| Dental Clinic/Center | 261QD0000X | Primary | ||
| Dental Laboratory | 292200000X |
Addresses
Primary practice location
2701 Frederick St
Shreveport, LA 71109-3607
Mailing address
11731 Emerald Lake Ave
Las Vegas, NV 89138-6403
Phone (702) 205-2623
National Provider Directory
National Provider DirectoryLocations
2701 Frederick St
Shreveport, LA 71109
Phone (318) 631-3464
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761696000000",
"number": "1033910567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11731 EMERALD LAKE AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891386403",
"telephone_number": "702-205-2623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 FREDERICK ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711093607",
"telephone_number": "702-205-2623"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SMILES ON WHEELS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-21",
"last_updated": "2025-10-29",
"certification_date": "2025-10-29",
"status": "A",
"authorized_official_last_name": "EVANS",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "702-205-2623"
},
"taxonomies": [
{
"code": "126900000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dental Laboratory Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
},
{
"code": "292200000X",
"taxonomy_group": "",
"desc": "Dental Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.