Axpm - Merkley, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

AXPM - MERKLEY, LLC

Doing business as

Southeast Smiles

Practice address

2116 Megan Dr.
Suite 101
Cape Girardeau, MO 63701

Phone

(573) 296-2898

Fax

(573) 349-4391

NPI assigned

Oct 21, 2014

Last updated

Oct 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Merritt Dake, CPA

Title

Manager/Owner

Phone

(501) 781-2777

Specialties & licenses 1

Addresses

Other names 1

• Southeast Smiles Doing business as

Tax ID family

Axpm - Merkley LLC2 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.

• Axpm - Merkley, LLC

  dba Stryker Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lebanon, MO
  • NPI 1457861320
  NPD tax ID

Locations

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1225432172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 TALLEY ROAD",
            "address_2": "SUITE 100",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72204",
            "telephone_number": "501-781-2777",
            "fax_number": "501-781-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 MEGAN DR.",
            "address_2": "SUITE 101",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "63701",
            "telephone_number": "573-296-2898",
            "fax_number": "573-349-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXPM - MERKLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "DAKE",
        "authorized_official_first_name": "MERRITT",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "501-781-2777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Hearnes August
• Amy R Augustine
• Aureus Health Services, LLC (Special Design Healthcare)
• April Austin
• Jessica Austin, LAT,ATC
• Allison Ayers
• David Jeffery Babcock, D.O.
• Taylor Babich, FNP-C
• Betty Jennell Bach, C.R.N.A.
• Katlyn Elizabeth Bader, MSN, APRN, FNP-BC

• Pediatric Dentistry in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Pediatric Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.