NPIMap

Organization Active NPI

Advanced Smile Center

  • General Practice Dentistry
  • Austin, TX
National Provider Identifier
1104154251
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16589 Issued in TX
Legal business name
ADVANCED SMILE CENTER
Practice address
3407 Wells Branch Pkwy Ste 700
Austin, TX 78728-6619
Phone
(512) 244-7677
Fax
(512) 244-9672
NPI assigned
Dec 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Authorized official

Name
Fatemeh SamaniNPI 1245287424
Title
DDS
Phone
(512) 244-7677

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 16589 TX Primary

Addresses

Primary practice location

3407 Wells Branch Pkwy Ste 700
Austin, TX 78728-6619

Mailing address

3407 Wells Branch Pkwy Ste 700
Austin, TX 78728-6619
Phone (512) 244-7677

Other identifiers 1

IdentifierTypeStateIssuer
16598MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1259625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259625600000",
    "number": "1104154251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 WELLS BRANCH PKWY STE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787286619",
            "telephone_number": "512-244-7677",
            "fax_number": "512-244-9672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 WELLS BRANCH PKWY STE 700",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787286619",
            "telephone_number": "512-244-7677",
            "fax_number": "512-244-9672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SMILE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-01",
        "last_updated": "2009-12-01",
        "status": "A",
        "authorized_official_last_name": "SAMANI",
        "authorized_official_first_name": "FATEMEH",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "512-244-7677"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "16589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16598",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.