Brilliant Smiles Dental Group - Havertown

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DS035966 Issued in PA

Legal business name

BRILLIANT SMILES DENTAL GROUP - HAVERTOWN

Doing business as

Elegant Smiles

Practice address

301 W Chester Pike
Suite 202
Havertown, PA 19083-4530

Phone

(610) 789-9400

Fax

(610) 789-2841

NPI assigned

Jul 17, 2015

Organization subpart

No

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

Authorized official

Name

Michelle Aitken, DDS

Title

Owner

Phone

(610) 789-9400

Specialties & licenses 1

Addresses

Other names 1

• Elegant Smiles Doing business as

Locations

Practitioners 2

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

• Barbara L Neilson, D.M.D.

  • General Practice Dentistry
  • Havertown, PA
  • NPI 1558489559
  NPD (past)
• Howard F Neilson, D.M.D.

  • General Practice Dentistry
  • Havertown, PA
  • NPI 1700904711
  NPD (past)

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1306220496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W CHESTER PIKE",
            "address_2": "SUITE 202",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834530",
            "telephone_number": "610-789-9400",
            "fax_number": "610-789-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W CHESTER PIKE",
            "address_2": "SUITE 202",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190834530",
            "telephone_number": "610-789-9400",
            "fax_number": "610-789-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT SMILES DENTAL GROUP - HAVERTOWN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "AITKEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-789-9400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS035966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elegant Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Boyd
• John David Bradford II, DMD
• Megan Marie Breslin, CRNP
• Misha H Briere, DO
• Bright Choice Dental LLC
• Troy L Brindle, M.S.W. L.C.S.W.
• Emily Suzanne Broach, CRNP
• Brooke Knows Breast, LLC
• Caryn Anderson Brooks, LPC, CAADC
• Broomall Pediatric Dentistry & Orthodontics,P.C.

• Dental Clinic/Center in Havertown, PA
• Providers in Havertown, PA by specialty
• Dental Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.