NPIMap

Organization Active NPI

Smiles 4 Kids 111 LLC

  • Dental Clinic/Center
  • Eagle, CO
National Provider Identifier
1255660080
Registry record updated Dec 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8632 Issued in CO
Legal business name
SMILES 4 KIDS 111 LLC
Practice address
50 Chamber Ave
Eagle, CO 81631
Phone
(970) 249-8595
NPI assigned
Dec 7, 2009
Last updated
Dec 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2009

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

Authorized official

Name
Benjamin George Wilson, DDS
Title
Owner
Phone
(970) 249-8595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8632 CO Primary

Addresses

Primary practice location

50 Chamber Ave
Eagle, CO 81631

Mailing address

1601 Oxbow Drive
Suite 360 a
Montrose, CO 81401
Phone (970) 249-8595

National Provider Directory

National Provider Directory

Locations

1601 Oxbow Dr
Unit 360-A
Montrose, CO 81401
Phone (970) 249-8595

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1255660080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 OXBOW DRIVE",
            "address_2": "SUITE 360 A",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "81401",
            "telephone_number": "970-249-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CHAMBER AVE",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "81631",
            "telephone_number": "970-249-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES 4 KIDS 111 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-249-8595",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "8632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.