Kethcart Smiles PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6695 Issued in AZ

Legal business name

KETHCART SMILES PLLC

Practice address

1277 E Missouri Ave Ste 102
Phoenix, AZ 85014-2916

Phone

(602) 615-8516

Fax

(602) 883-7252

NPI assigned

Jun 17, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Kethcart, DDS

Title

Owner

Phone

(602) 615-8516

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Kethcart DDS SOLE MBR Other name

Practitioners 1

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

• Stephanie Ann Wagner Kethcart, DDS

  • General Practice Dentistry
  • Phoenix, AZ
  • NPI 1508897406
  NPD

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565395200000",
    "number": "1245680438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142916",
            "telephone_number": "602-615-8516",
            "fax_number": "602-883-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E MISSOURI AVE STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142916",
            "telephone_number": "602-615-8516",
            "fax_number": "602-883-7252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "727 E Bethany Home Rd",
            "address_2": "#A100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850142156",
            "country_code": "US",
            "telephone_number": "602-789-3799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KETHCART SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-17",
        "last_updated": "2019-08-10",
        "status": "A",
        "authorized_official_last_name": "KETHCART",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-615-8516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D6695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stephanie Kethcart DDS SOLE MBR",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Stephanie Kethcart DDS SOLE MBR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sanjay Kestner, MC LPC
• Christina Mae Keszler, D.C.
• Ketamine Infusion Centers, Inc
• Ketamine Wellness Centers Phoenix LLC
• Kethcart Sleep LLC
• Kristoffer J Keul, LAC (LICENSED ASSOCI
• Katherine Keuth, LAMFT
• Angie Buono Kevane, RDH, BSDH
• Kevin J Lythgoe MD PC
• Kevin J Ortale DDS

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

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