Smiles Dental Group, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SMILES DENTAL GROUP, PC

Practice address

820 Ocean Beach Hwy
Suite 110
Longview, WA 98632-4080

Phone

(360) 261-6094

Fax

(360) 423-3343

NPI assigned

Feb 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. Fredrick C Thompson, D.M.D.

Title

Chief Dental Officer

Phone

(503) 332-8646

Specialties & licenses 10

Addresses

Other names 1

• SMILES DENTAL GROUP, PC WA Other name

Tax ID family

Smiles Dental Group PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Smiles Dental Group, PC

  • Customized Equipment (DME)
  • Woodburn, OR
  • NPI 1295149334
  NPD tax ID
• Smiles Dental Group, PC

  • General Practice Dentistry
  • Salem, OR
  • NPI 1427417526
  NPD tax ID

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1285093385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FIR ST",
            "address_2": "SUITE 1D",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322544",
            "telephone_number": "360-261-6094",
            "fax_number": "360-423-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY",
            "address_2": "SUITE 110",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324080",
            "telephone_number": "360-261-6094",
            "fax_number": "360-423-3343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF DENTAL OFFICER",
        "authorized_official_telephone_number": "503-332-8646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILES DENTAL GROUP, PC WA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SMILES DENTAL GROUP, PC WA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Slotte, RPH
• Randi Lynn Slotte, RPH
• Fay Slusher
• Anne Mette Kristiane Smeenk, M.D.
• Riley N Smetzler
• Ashley Smith
• Carolina Kato Smith, MD
• Emily A Smith, BS, R-AAC
• Fran J Smith, MSW
• Ian Michael Smith, CPO

• Dentist in Longview, WA
• Providers in Longview, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; 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.