King Smile Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D7308 Issued in OR

Legal business name

KING SMILE DENTISTRY LLC

Doing business as

King Smile Dentistry

Practice address

10555 SE 82ND Ave
Ste. 105
Happy Valley, OR 97086-2374

Phone

(503) 344-6334

NPI assigned

Nov 24, 2015

Organization subpart

No

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

Authorized official

Name

Phu Thi Bui, DDS

Title

President

Phone

(503) 344-6334

Specialties & licenses 1

Addresses

Other names 1

• King Smile Dentistry Doing business as

Locations

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1316311657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 SE 82ND AVE",
            "address_2": "STE. 105",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970862374",
            "telephone_number": "503-344-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 SE 82ND AVE",
            "address_2": "STE. 105",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970862374",
            "telephone_number": "503-344-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING SMILE DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "BUI",
        "authorized_official_first_name": "PHU",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-344-6334",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Smile Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith Miller OD PC
• Carol Ann Keller, RPH
• Joshua Benjamin Kelso
• Darcy Brook Kennedy, LCSW
• Holly Michelle Kiesz-Royer, SLP
• Jamelle King
• Jacob Gabriel Kirkwood, PMHNP
• David J Klarberg, FNP-BC
• Laurie Akemi Kobatake, OTRL
• Vera Krasnogorov

• Dentist in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.