Smiles Divine Dental TMD Craniofacial Pain Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5366 Issued in AZ

Legal business name

SMILES DIVINE DENTAL TMD CRANIOFACIAL PAIN CENTER

Practice address

6003 W Thunderbird Rd Ste 2
Glendale, AZ 85306-4004

Phone

(602) 283-3545

Fax

(602) 283-3545

NPI assigned

Nov 3, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Neil Depante Tobias

Title

Sole Member

Phone

(602) 283-3545

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459296000000",
    "number": "1295130292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 W THUNDERBIRD RD STE 2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064004",
            "telephone_number": "602-283-3545",
            "fax_number": "602-283-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 W THUNDERBIRD RD STE 2",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064004",
            "telephone_number": "602-283-3545",
            "fax_number": "602-283-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES DIVINE DENTAL TMD CRANIOFACIAL PAIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2016-03-30",
        "status": "A",
        "authorized_official_last_name": "TOBIAS",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "DEPANTE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "602-283-3545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "5366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "559809",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Michael Smich, RPH
• Kristin Suzanne Smidt, MASTERS OF SCIENCE
• Smile Science, PLLC
• Smile Today Arrowhead, LLC
• Smile Transformation Centre LLC
• Smiles of America-Arrowhead PLLC
• Smith Chiropractic Center at Arrowhead
• Alexander Eric Smith, DMD
• Brandi Smith
• Cindi L. Smith, OCCUPATIONAL THERAPI

• General Practice Dentistry in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.