NPIMap

Organization Active NPI

Seaside Smiles, PLLC

  • Pediatric Dentistry
  • Wolfeboro, NH
National Provider Identifier
1053013441
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SEASIDE SMILES, PLLC
Practice address
76 N. Main St.
Wolfeboro, NH 03894
Phone
(603) 280-4500
NPI assigned
Mar 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Andrew Hall
Title
Business Manager
Phone
(603) 280-4500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

76 N. Main St.
Wolfeboro, NH 03894

Mailing address

PO Box 1498
Alton, NH 03809-1498
Phone (603) 280-4500

Other identifiers 1

IdentifierTypeStateIssuer
3138977MedicaidNH

Other names 1

  • Lakeside Smiles Pediatric Dentistry, PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lakeside Smiles Pediatric Dentistry PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1053013441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1498",
            "city": "ALTON",
            "state": "NH",
            "postal_code": "038091498",
            "telephone_number": "603-280-4500",
            "fax_number": "603-632-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 N. MAIN ST.",
            "city": "WOLFEBORO",
            "state": "NH",
            "postal_code": "03894",
            "telephone_number": "603-280-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE SMILES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "603-280-4500"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3138977",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Smiles Pediatric Dentistry, PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lakeside Smiles Pediatric Dentistry, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wolfeboro, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.