Smile Center of Debary, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILE CENTER OF DEBARY, LLC

Practice address

54 Spring Vista Dr
Debary, FL 32713-3269

Phone

(386) 753-0036

Fax

(386) 753-0802

NPI assigned

Feb 21, 2024

Organization subpart

No

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

Authorized official

Name

Daniel Jimenez

Title

Chief Operating Officer

Phone

(407) 529-6814

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1306601034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SPRING VISTA DR",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327133269",
            "telephone_number": "386-753-0036",
            "fax_number": "386-753-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SPRING VISTA DR",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327133269",
            "telephone_number": "386-753-0036",
            "fax_number": "386-753-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CENTER OF DEBARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "407-529-6814"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Debary, FL
• Providers in Debary, FL by specialty
• Dental Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.