Smiles to Go, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

3412-07 Issued in MS

Legal business name

SMILES TO GO, LLC

Practice address

214 Claiborne St
Liberty, MS 39645-8179

Phone

(601) 551-2003

Fax

(601) 657-5889

NPI assigned

Dec 3, 2014

Last updated

Jan 20, 2015By 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

Sarah Ashley Casey, BSN, MBA, MPH, NHA

Title

Owner

Phone

(601) 551-2003

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1043617277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 CLAIBORNE ST",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396458179",
            "telephone_number": "601-551-2003",
            "fax_number": "601-657-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 CLAIBORNE ST",
            "city": "LIBERTY",
            "state": "MS",
            "postal_code": "396458179",
            "telephone_number": "601-551-2003",
            "fax_number": "601-657-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES TO GO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-03",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-551-2003",
        "authorized_official_credential": "BSN, MBA, MPH, NHA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3412-07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730387655",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.