NPIMap

Organization Active NPI

Smiling Kidds Dentistry, P.a.

Doing business as Kissimmee Children's Dentistry

  • Pediatric Dentistry
  • Kissimmee, FL
National Provider Identifier
1083383582
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SMILING KIDDS DENTISTRY, P.A.
Doing business as
Kissimmee Children's Dentistry
Practice address
595 Oak Commons Blvd Ste C
Kissimmee, FL 34741-4211
Phone
(407) 870-0717
NPI assigned
Sep 8, 2021
Organization subpart
Yes
Parent organization
SMILING KIDDS DENTISTRY, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Authorized official

Name
Mr. Andrew Weaver
Title
Practice Administrator
Phone
(904) 395-7772

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

595 Oak Commons Blvd Ste C
Kissimmee, FL 34741-4211

Mailing address

3030 Hartley Rd Ste 310
Jacksonville, FL 32257-8213
Phone (904) 395-7772

Other names 1

  • Kissimmee Children's Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Smiling Kidds Dentistry PA8 organizations share this tax ID, including this one
Part of
Smiling Kidds Dentistry PA

Other organizations with this tax ID 7

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": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1083383582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 HARTLEY RD STE 310",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578213",
            "telephone_number": "904-395-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 OAK COMMONS BLVD STE C",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414211",
            "telephone_number": "407-870-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILING KIDDS DENTISTRY, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILING KIDDS DENTISTRY, P.A.",
        "enumeration_date": "2021-09-08",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-395-7772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kissimmee Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kissimmee Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.