NPIMap

Organization Active NPI

Beautiful Smiles Dental LLC

  • General Practice Dentistry
  • Bothell, WA
National Provider Identifier
1194991646
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00010721 Issued in WA
Legal business name
BEAUTIFUL SMILES DENTAL LLC
Practice address
18521 101St Ave NE
Bothell, WA 98011-3803
Phone
(425) 487-1551
Fax
(425) 487-2160
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Ms. Tate Todorovic
Title
Office Manager
Phone
(425) 487-1551

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DE00010721 WA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DE00010705 WA
ProsthodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0700X DE00009891 WA
DenturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122400000X DN00000331 WA

Addresses

Primary practice location

18521 101St Ave NE
Bothell, WA 98011-3803

Mailing address

18521 101St Ave NE
Bothell, WA 98011-3803
Phone (425) 487-1551

National Provider Directory

National Provider Directory

Locations

18521 101st Ave NE
Bothell, WA 98011
Phone (425) 487-1551

Practitioners & affiliated clinicians

Practitioners 1

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": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1194991646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18521 101ST AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113803",
            "telephone_number": "425-487-1551",
            "fax_number": "425-487-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18521 101ST AVE NE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113803",
            "telephone_number": "425-487-1551",
            "fax_number": "425-487-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL SMILES DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "TODOROVIC",
        "authorized_official_first_name": "TATE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-487-1551",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010721",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010705",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00009891",
            "primary": false
        },
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.