NPIMap

Organization Active NPI

Smile Designers LLC

  • General Practice Dentistry
  • Philadelphia, PA
National Provider Identifier
1255628608
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS035070 Issued in PA
Legal business name
SMILE DESIGNERS LLC
Practice address
7234 Rising Sun Ave
Philadelphia, PA 19111-3948
Phone
(215) 745-4313
Fax
(215) 745-4388
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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

Authorized official

Name
Mr. Sajjad Malik
Title
Manager
Phone
(215) 745-4313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DS035070 PA Primary

Addresses

Primary practice location

7234 Rising Sun Ave
Philadelphia, PA 19111-3948

Mailing address

7234 Rising Sun Ave
Philadelphia, PA 19111-3948
Phone (215) 745-4313

Other identifiers 1

IdentifierTypeStateIssuer
1023308680002MedicaidPA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1255628608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7234 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113948",
            "telephone_number": "215-745-4313",
            "fax_number": "215-745-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7234 RISING SUN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191113948",
            "telephone_number": "215-745-4313",
            "fax_number": "215-745-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE DESIGNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "SAJJAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-745-4313",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023308680002",
            "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 Jul 6, 2011; 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.