Smart Dental Care Prairieville, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5491 Issued in LA

Legal business name

SMART DENTAL CARE PRAIRIEVILLE, LLC

Practice address

37290 Old Perkins Rd
Prairieville, LA 70769-3764

Phone

(225) 677-9999

Fax

(225) 677-9993

NPI assigned

Apr 17, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Emmett Moore, D.D.S.

Title

Doctor/Owner

Phone

(225) 677-9999

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Tyler Ryan Mullins, DDS

  • Dentist
  • Prairieville, LA
  • NPI 1609515436
  NPD (past)

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1275067282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37290 OLD PERKINS RD",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693764",
            "telephone_number": "225-677-9999",
            "fax_number": "225-677-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37290 OLD PERKINS RD",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693764",
            "telephone_number": "225-677-9999",
            "fax_number": "225-677-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART DENTAL CARE PRAIRIEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-17",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "EMMETT",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "225-677-9999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Shockey, LMSW
• Haley Shows
• Kendal Marie Sigur
• Alivia Simmons
• Khadijah Kashay Simmons, MSW, LMSW
• Alexus Jakai Smith, BCABA
• Christina Smith, D.N.M.
• Kenya Smith
• Kimberly B. Smith, M.A., CCC-SLP
• Lillian Grace Smith

• General Practice Dentistry in Prairieville, LA
• Providers in Prairieville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.