NPIMap

Organization Active NPI

Wichita Smiles

Doing business as Smart Mouth Family Dental

  • Dentist
  • Wichita Falls, TX
National Provider Identifier
1154708162
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30183 Issued in TX
Legal business name
WICHITA SMILES
Doing business as
Smart Mouth Family Dental
Practice address
2120 Virginia Dr Ste a
Wichita Falls, TX 76309-4646
Phone
(940) 761-5979
Fax
(903) 465-1134
NPI assigned
Apr 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Authorized official

Name
Dr. Jeffrey Bullock Johnson, DDSNPI 1992110894
Title
Dentist
Phone
(940) 761-5979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 30183 TX Primary

Addresses

Primary practice location

2120 Virginia Dr Ste a
Wichita Falls, TX 76309-4646

Mailing address

2120 Virginia Dr Ste a
Wichita Falls, TX 76309-4646
Phone (940) 761-5979

Other names 1

  • Smart Mouth Family Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1154708162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 VIRGINIA DR STE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094646",
            "telephone_number": "940-761-5979",
            "fax_number": "903-465-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 VIRGINIA DR STE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094646",
            "telephone_number": "940-761-5979",
            "fax_number": "903-465-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-28",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "BULLOCK",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "940-761-5979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "30183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smart Mouth Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.