Smile Envy Family Dentistry, L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE ENVY FAMILY DENTISTRY, L.L.C.

Practice address

10144 W Lake Pleasant Pkwy
Suite 1100
Peoria, AZ 85382-9716

Phone

(623) 825-3689

Fax

(623) 825-3695

NPI assigned

Aug 3, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Diedra A Ivey

Title

Office Manager

Phone

(623) 825-3689

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249257600000",
    "number": "1194956532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10144 W LAKE PLEASANT PKWY",
            "address_2": "SUITE 1100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829716",
            "telephone_number": "623-825-3689",
            "fax_number": "623-825-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10144 W LAKE PLEASANT PKWY",
            "address_2": "SUITE 1100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829716",
            "telephone_number": "623-825-3689",
            "fax_number": "623-825-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE ENVY FAMILY DENTISTRY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A",
        "authorized_official_last_name": "IVEY",
        "authorized_official_first_name": "DIEDRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "623-825-3689",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Peoria, AZ
• Providers in Peoria, 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 Aug 3, 2009; 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.