Lie Charleston Smiles Dentistry, PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LIE CHARLESTON SMILES DENTISTRY, PC

Practice address

1150 S Nellis Blvd Ste 200
Las Vegas, NV 89104-5700

Phone

(714) 845-8500

NPI assigned

May 30, 2018

Organization subpart

No

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

Authorized official

Name

Wanni Lie

Title

Owner

Phone

(714) 845-8500

Specialties & licenses 1

Addresses

Other names 1

• Charleston Smiles Dentistry Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1306338033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S NELLIS BLVD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891045700",
            "telephone_number": "714-845-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIE CHARLESTON SMILES DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "LIE",
        "authorized_official_first_name": "WANNI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-845-8500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charleston Smiles Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Liddle
• Daniel Lide
• J'Ree J'Nel Lide
• Julie Marie Woods Lide, PA-C
• Takar Lide
• Wanni Lie
• Richard D Lieber, MD
• Douglas Jason Lieberman
• Rebecca A Liebert, APN
• Jonathan T Liebig, M.D.

• Dentist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Dentist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.