My Smile Artist, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MY SMILE ARTIST, PLLC

Doing business as

my smile artist

Practice address

1130 E Sonterra Blvd Ste 110
San Antonio, TX 78258-4236

Phone

(210) 496-9967

NPI assigned

Oct 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Imam, DDS, BDSNPI 1356756514

Title

Dentist

Phone

(210) 496-9967

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• my smile artist Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamed Imam, DDS

  • Dentist
  • San Antonio, TX
  • NPI 1356756514
  NPD Authorized official
• Brian K. Schroder, DDS

  • General Practice Dentistry
  • San Antonio, TX
  • NPI 1770677445
  NPD (past)

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1205478377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 E SONTERRA BLVD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584236",
            "telephone_number": "210-496-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 E SONTERRA BLVD STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584236",
            "telephone_number": "210-496-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY SMILE ARTIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "210-496-9967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, BDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770677445",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "my smile artist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• My Nutrition Studio
• My Own Hospice
• My Own Hospice LLC
• My Own Optical LLC
• My Own Optical LLC
• Julie Ann Mydland, RN
• Matthew David Mydland, RN
• Abigail C Myers, MD
• Barbara M Myers, R.N., NP
• Christine Myers

• Dental Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.