The Smile Shop Inc

Primary specialty

DentistTaxonomy code 122300000X

License

3627 Issued in KY

Legal business name

THE SMILE SHOP INC

Practice address

3650 Boston Rd
Suite K
Lexington, KY 40514

Phone

(859) 223-7300

Fax

(859) 223-1122

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Robert B Shacklette, DMD

Title

Owner

Phone

(859) 223-7300

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Solitaire Shacklette Wix, DMD

  • General Practice Dentistry
  • Lexington, KY
  • NPI 1134398019
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336224484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 BOSTON RD",
            "address_2": "SUITE K",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40514",
            "telephone_number": "859-223-7300",
            "fax_number": "859-223-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 BOSTON RD",
            "address_2": "SUITE K",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40514",
            "telephone_number": "859-223-7300",
            "fax_number": "859-223-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SMILE SHOP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHACKLETTE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-223-7300",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "KY",
            "license": "3627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lexington, KY
• Providers in Lexington, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.