Smile Fresh Detroit PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901021727 Issued in MI

Legal business name

SMILE FRESH DETROIT PC

Doing business as

Smile Fresh Dental

Practice address

7230 Gratiot Avenue
Detroit, MI 48213

Phone

(248) 895-6987

NPI assigned

Mar 20, 2017

Last updated

Mar 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fauzi Mohammed Raziuddin

Title

Office Manager

Phone

(248) 895-6987

Specialties & licenses 1

Addresses

Other names 1

• SMILE FRESH DENTAL Doing business as

Locations

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1164963401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 THREADNEEDLE ST",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041020",
            "telephone_number": "248-895-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7230 GRATIOT AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48213",
            "telephone_number": "248-895-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE FRESH DETROIT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "RAZIUDDIN",
        "authorized_official_first_name": "FAUZI",
        "authorized_official_middle_name": "MOHAMMED",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "248-895-6987"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILE FRESH DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia K Smeal, MD
• Robert Dale Smeed Jr., D.O.
• Ashley Smeltzer
• Stefan H Smietana, D.O.
• Jenna Smigielski
• Smiles for Days Homecare Agency
• Smiles of Tomorrow, P.C.
• Smiley Dental of Eight Mile Road, PC
• Smiley Dental of Livernois Ave PC
• Smiley Dental of Plymouth Road, PC

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.