Organization Active NPI

Creating New Smiles ASC, LLC

  • Dental Clinic/Center
  • Norfolk, VA
National Provider Identifier
1124913561
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CREATING NEW SMILES ASC, LLC
Practice address
1682 Church St
Norfolk, VA 23504-2346
Phone
(757) 683-0143
Fax
(757) 901-0613
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Dr. Jim Ervil, DDS
Title
Owner
Phone
(804) 615-9682

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1682 Church St
Norfolk, VA 23504-2346

Mailing address

4936 Limestone Ave
Virginia Beach, VA 23462-4430

Other names 1

  • Creating New Smiles, ASC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1124913561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4936 LIMESTONE AVE",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234624430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1682 CHURCH ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235042346",
            "telephone_number": "757-683-0143",
            "fax_number": "757-901-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING NEW SMILES ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "ERVIL",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-615-9682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creating New Smiles, ASC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

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