Super Smiles 4 Kids CG, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SUPER SMILES 4 KIDS CG, PLLC

Practice address

1295 E Florence Blvd Ste 4
Casa Grande, AZ 85122-4299

Phone

(520) 436-0843

Fax

(520) 436-0105

NPI assigned

Jul 27, 2023

Organization subpart

No

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

Authorized official

Name

Dora Pesqueda, MEMBER

Title

Director of Operations

Phone

(520) 436-0843

Specialties & licenses 1

Addresses

Other names 1

• Super Smiles 4 Families Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mariah Taylor, RDH AP

  • Dental Hygienist
  • Casa Grande, AZ
  • NPI 1144083759
  NPD
• Bret M Ford, DDS

  • Dentist
  • Mesa, AZ
  • NPI 1245223916
  NPD (past)
• Nikita Kuppanda

  • Pediatric Dentistry
  • Maricopa, AZ
  • NPI 1649648668
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775174400000",
    "number": "1144901547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 E FLORENCE BLVD STE 4",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224299",
            "telephone_number": "520-436-0843",
            "fax_number": "520-436-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 E FLORENCE BLVD STE 4",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224299",
            "telephone_number": "520-436-0843",
            "fax_number": "520-436-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPER SMILES 4 KIDS CG, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A",
        "authorized_official_last_name": "PESQUEDA",
        "authorized_official_first_name": "DORA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "520-436-0843",
        "authorized_official_credential": "MEMBER"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Smiles 4 Families",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sun Life Family Health Center, Inc.
• Sun Valley Physical Medicine and Rehabilitation
• Sunlight Forever Family
• Sunny Side Group Home LLC
• Sunshine Child & Adolescent Care, Inc.
• Super Smiles for Kids, LLC
• Suresh Balenalli, PLLC
• Surgical Specialties of Casa Grande
• Hayley Michele Swain, RN
• Syangi Healthcare LLC

• General Practice Dentistry in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2026; 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.