NPIMap

Organization Active NPI

Southern Smiles Dental PLLC

  • Dental Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1043937360
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SOUTHERN SMILES DENTAL PLLC
Practice address
4731 E Southern Ave
Phoenix, AZ 85042-4150
Phone
(480) 530-0755
NPI assigned
Oct 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Dr. Ghassan Sheikh Sroujieh, DDSNPI 1366519456
Title
Owner
Phone
(480) 530-0754

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4731 E Southern Ave
Phoenix, AZ 85042-4150

Mailing address

4731 E Southern Ave
Phoenix, AZ 85042-4150
Phone (480) 530-0755

National Provider Directory

National Provider Directory

Locations

4731 E Southern Ave
Phoenix, AZ 85042
Phone (480) 530-0755

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": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1043937360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4731 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850424150",
            "telephone_number": "480-530-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 E SOUTHERN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850424150",
            "telephone_number": "480-530-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "SHEIKH SROUJIEH",
        "authorized_official_first_name": "GHASSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-530-0754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.