Smile Bright Dental Corporation

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

SMILE BRIGHT DENTAL CORPORATION

Practice address

414 Tennessee St Ste K1
Redlands, CA 92373-8152

Phone

(909) 798-4000

NPI assigned

May 7, 2019

Organization subpart

No

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

Authorized official

Name

Francisco Donavanik Fores, DDS

Title

Ceo

Phone

(661) 917-0507

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1316502123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 E HOLT AVE STE 202",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 TENNESSEE ST STE K1",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738152",
            "telephone_number": "909-798-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE BRIGHT DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "FORES",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "DONAVANIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-917-0507",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in Redlands, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.