NPIMap

Organization Active NPI

An Elegant Smile P.C.

Doing business as An Elegant Smile Dentistry

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1053631309
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AN ELEGANT SMILE P.C.
Doing business as
An Elegant Smile Dentistry
Practice address
1425 S Greenfield Rd
BLDG 2 Ste 110
Mesa, AZ 85206-5529
Phone
(480) 854-3434
Fax
(480) 854-2640
NPI assigned
Jun 9, 2010
Last updated
Jun 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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

Authorized official

Name
Monica Vitela
Title
Credentialing Coordinator
Phone
(602) 482-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X

Addresses

Primary practice location

1425 S Greenfield Rd
BLDG 2 Ste 110
Mesa, AZ 85206-5529

Mailing address

1425 S Greenfield Rd
BLDG 2 Ste 110
Mesa, AZ 85206-5529
Phone (480) 854-3434

Other names 1

  • An Elegant Smile Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
An Elegant Smile PC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276041600000",
    "number": "1053631309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD",
            "address_2": "BLDG 2 STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065529",
            "telephone_number": "480-854-3434",
            "fax_number": "480-854-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD",
            "address_2": "BLDG 2 STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065529",
            "telephone_number": "480-854-3434",
            "fax_number": "480-854-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AN ELEGANT SMILE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A",
        "authorized_official_last_name": "VITELA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "602-482-7000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "An Elegant Smile Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.