Smile & Aesthetics 360 Dental & Medspa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE & AESTHETICS 360 DENTAL & MEDSPA

Practice address

12606 Greenville Ave Ste 230
Dallas, TX 75243-1921

Phone

(219) 308-7221

NPI assigned

Jun 25, 2024

Organization subpart

No

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

Authorized official

Name

Juveria Fakhruddin

Title

Dentist

Phone

(219) 308-7221

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1093550733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 NICKELVILLE LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750985395",
            "telephone_number": "219-308-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12606 GREENVILLE AVE STE 230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431921",
            "telephone_number": "219-308-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE & AESTHETICS 360 DENTAL & MEDSPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "FAKHRUDDIN",
        "authorized_official_first_name": "JUVERIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "219-308-7221"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Edwin Smeeding, RPH
• Ashton Mark Smelser
• Eric Nathan Smernoff, PH. D.
• Michael John Smerud, MD
• SMG Supplies LLC
• Smile Builders Dental Center PC
• Smile Care, PLLC
• Smile Embassy, PLLC.
• Smile Metroplex Family Dentistry Cockrell Hill PLLC
• Smile Metroplex Family Dentistry Masters PLLC

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.