NPIMap

Organization Active NPI

Premier Smile Center

  • General Practice Dentistry
  • Fort Lauderdale, FL
National Provider Identifier
1205215225
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN15991 Issued in FL
Legal business name
PREMIER SMILE CENTER
Practice address
2717 E Oakland Park Blvd
Suite 100
Fort Lauderdale, FL 33306-1664
Phone
(954) 566-7479
Fax
(954) 306-6910
NPI assigned
May 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

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

Authorized official

Name
Dr. Charmaine Aubrey Johnson-Leong, D.D.S.NPI 1497134480
Title
Owner
Phone
(954) 566-7479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN15991 FL Primary

Addresses

Primary practice location

2717 E Oakland Park Blvd
Suite 100
Fort Lauderdale, FL 33306-1664

Mailing address

2717 E Oakland Park Blvd
Suite 100
Fort Lauderdale, FL 33306-1664
Phone (954) 566-7479

National Provider Directory

National Provider Directory
Tax ID family
Charmaine Johnson-Leong DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2717 E Oakland Park Blvd
Ste 100
Fort Lauderdale, FL 33306
Phone (954) 566-7479

Practitioners & affiliated clinicians

Practitioners 6

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": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1205215225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 E OAKLAND PARK BLVD",
            "address_2": "SUITE 100",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061664",
            "telephone_number": "954-566-7479",
            "fax_number": "954-306-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2717 E OAKLAND PARK BLVD",
            "address_2": "SUITE 100",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061664",
            "telephone_number": "954-566-7479",
            "fax_number": "954-306-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SMILE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-LEONG",
        "authorized_official_first_name": "CHARMAINE",
        "authorized_official_middle_name": "AUBREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-566-7479",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.