NPIMap

Organization Active NPI

Smile Team PC

  • Dental Clinic/Center
  • Philadelphia, PA
National Provider Identifier
1215574355
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SMILE TEAM PC
Practice address
9301 Banes St
Philadelphia, PA 19115-4201
Phone
(215) 709-0001
Fax
(215) 709-6002
NPI assigned
Dec 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Dr. Bansi DoescherNPI 1720392491
Title
Owner
Phone
(215) 709-0001

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

9301 Banes St
Philadelphia, PA 19115-4201

Mailing address

9301 Banes St
Philadelphia, PA 19115-4201
Phone (215) 709-0001

Other identifiers 1

IdentifierTypeStateIssuer
1035067790001MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Smile Team PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1575849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1215574355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 BANES ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154201",
            "telephone_number": "215-709-0001",
            "fax_number": "215-709-6002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 BANES ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154201",
            "telephone_number": "215-709-0001",
            "fax_number": "215-709-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE TEAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "DOESCHER",
        "authorized_official_first_name": "BANSI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-709-0001",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035067790001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.