NPIMap

Organization Active NPI

Southern Smiles, Family & Cosmetic Dentistry

  • Dentist
  • College Station, TX
National Provider Identifier
1063957991
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
23796 Issued in TX
Legal business name
SOUTHERN SMILES, FAMILY & COSMETIC DENTISTRY
Practice address
1132 Midtown Drive
College Station, TX 77845
Phone
(979) 846-7799
Fax
(979) 326-1510
NPI assigned
Jan 2, 2017
Last updated
Jun 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Authorized official

Name
Mr. Patrick Stewart Burchfield, DDSNPI 1376523290
Title
Owner/Dentist
Phone
(979) 846-7799

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22821 TX
Dentist 122300000X 23796 TX Primary

Addresses

Primary practice location

1132 Midtown Drive
College Station, TX 77845

Mailing address

1132 Midtown Drive
College Station, TX 77845
Phone (979) 846-7799

National Provider Directory

National Provider Directory

Locations

1132 Midtown Dr
College Station, TX 77845
Phone (979) 846-7799

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1483315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1063957991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 MIDTOWN DRIVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-846-7799",
            "fax_number": "979-326-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 MIDTOWN DRIVE",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "77845",
            "telephone_number": "979-846-7799",
            "fax_number": "979-326-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN SMILES, FAMILY & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-02",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "BURCHFIELD",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "979-846-7799",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22821",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "23796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.