NPIMap

Organization Active NPI

Smile Straight Orthodontics-Central Ms PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, MS
National Provider Identifier
1205469111
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SMILE STRAIGHT ORTHODONTICS-CENTRAL MS PLLC
Practice address
1189 E County Line Rd Ste 1010
Jackson, MS 39211-1836
Phone
(601) 308-2022
Fax
(601) 326-2618
NPI assigned
Feb 19, 2020
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Authorized official

Name
Teresa Zwicky
Title
Credentialing Manager
Phone
(480) 866-8811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X NU Primary

Addresses

Primary practice location

1189 E County Line Rd Ste 1010
Jackson, MS 39211-1836

Mailing address

5717 E Thomas Rd Ste 110
Scottsdale, AZ 85251-7620
Phone (623) 282-9959

National Provider Directory

National Provider Directory
Tax ID family
Smile Straight Orthodontics4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1205469111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 E THOMAS RD STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517620",
            "telephone_number": "623-282-9959",
            "fax_number": "602-429-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 E COUNTY LINE RD STE 1010",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392111836",
            "telephone_number": "601-308-2022",
            "fax_number": "601-326-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE STRAIGHT ORTHODONTICS-CENTRAL MS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "ZWICKY",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "480-866-8811"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.