Tribe Dental LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

TRIBE DENTAL LLC

Doing business as

Smile Place

Practice address

11 Magnolia Cove Dr
Simpsonville, SC 29680

Phone

(864) 610-4485

NPI assigned

Dec 5, 2019

Last updated

Jan 5, 2020By 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

Dr. Leanna Shetler, DMDNPI 1811251036

Title

Owner

Phone

(724) 263-8210

Specialties & licenses 1

Addresses

Other names 1

• Smile Place Doing business as

Locations

Practitioners 1

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.

• Leanna Christine Shetler, D.M.D

  • General Practice Dentistry
  • Simpsonville, SC
  • NPI 1811251036

  Pediatric Dentistry

  NPD Authorized official

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578182400000",
    "number": "1235776568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 KILGORE FARMS CIR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296816389",
            "telephone_number": "724-263-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MAGNOLIA COVE DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "29680",
            "telephone_number": "864-610-4485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 Batesville Rd",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296814816",
            "country_code": "US",
            "telephone_number": "864-610-4485 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRIBE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-01-05",
        "certification_date": "2020-01-05",
        "status": "A",
        "authorized_official_last_name": "SHETLER",
        "authorized_official_first_name": "LEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-263-8210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Pediatric Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2020; 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.