CR Smiles - Meridian Dental Care LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CR SMILES - MERIDIAN DENTAL CARE LLC

Practice address

1500 W Cayuse Creek Dr
#100
Meridian, ID 83646

Phone

(208) 893-5435

Fax

(208) 884-8915

NPI assigned

Nov 7, 2018

Last updated

Dec 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Calvin C Brown Jr., DDS

Title

Sole Member

Phone

(248) 798-7708

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1306314323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8285 W UNION HILLS DR #103",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-362-8200",
            "fax_number": "623-979-7364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W CAYUSE CREEK DR",
            "address_2": "#100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "208-893-5435",
            "fax_number": "208-884-8915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CR SMILES - MERIDIAN DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "248-798-7708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Meridian, ID
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.