NPIMap

Organization Active NPI

Smile Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Palmdale, CA
National Provider Identifier
1174940795
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
56758 Issued in CA
Legal business name
SMILE ORTHODONTICS
Practice address
2508 E Palmdale Blvd
Palmdale, CA 93550-4860
Phone
(661) 947-9990
Fax
(661) 947-2458
NPI assigned
Mar 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Authorized official

Name
Daniel Vincent Ruffolo, D.D.S.
Title
Orthodontist
Phone
(661) 947-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 56758 CA Primary

Addresses

Primary practice location

2508 E Palmdale Blvd
Palmdale, CA 93550-4860

Mailing address

2508 E Palmdale Blvd
Palmdale, CA 93550-4860
Phone (661) 947-9990

Other identifiers 1

IdentifierTypeStateIssuer
1477855245OtherCATYPE 1 NPI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1174940795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504860",
            "telephone_number": "661-947-9990",
            "fax_number": "661-947-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 E PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935504860",
            "telephone_number": "661-947-9990",
            "fax_number": "661-947-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "RUFFOLO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "661-947-9990",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "56758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1477855245",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.