Organization Active NPI

Smiles by Delivery, PLLC

  • Dentist
  • Surprise, AZ
National Provider Identifier
1295083202
Registry record updated Aug 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SMILES BY DELIVERY, PLLC
Practice address
15508 W Bell Rd
101-525
Surprise, AZ 85374-2432
Phone
(623) 584-4746
Fax
(623) 584-4750
NPI assigned
Aug 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2012

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

Authorized official

Name
Elaine Carmella Mamola, RDHNPI 1033467113
Title
RDH/Owner
Phone
(602) 717-7757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X H04804 AZ
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X H05302 AZ

Addresses

Primary practice location

15508 W Bell Rd
101-525
Surprise, AZ 85374-2432

Mailing address

15508 W Bell Rd
101-525
Surprise, AZ 85374-2432
Phone (623) 584-4746

National Provider Directory

National Provider Directory

Locations

15508 W Bell Rd
#101525
Surprise, AZ 85374
Phone (623) 584-4746

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1345593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345766400000",
    "number": "1295083202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15508 W BELL RD",
            "address_2": "101-525",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742432",
            "telephone_number": "623-584-4746",
            "fax_number": "623-584-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15508 W BELL RD",
            "address_2": "101-525",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742432",
            "telephone_number": "623-584-4746",
            "fax_number": "623-584-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES BY DELIVERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-22",
        "last_updated": "2012-08-24",
        "status": "A",
        "authorized_official_last_name": "MAMOLA",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "CARMELLA",
        "authorized_official_title_or_position": "RDH/OWNER",
        "authorized_official_telephone_number": "602-717-7757",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "H04804",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "H05302",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2012; 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.