Smiles General & Cosmetic Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

DN15993 Issued in FL

Legal business name

SMILES GENERAL & COSMETIC DENTISTRY

Practice address

4600 Military Trail
# 219
Jupiter, FL 33458

Phone

(561) 844-0715

Fax

(561) 776-4878

NPI assigned

Jul 23, 2007

Organization subpart

No

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

Authorized official

Name

Sharada Kacham

Title

Owner

Phone

(561) 844-0715

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1336349885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRAIL",
            "address_2": "# 219",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-844-0715",
            "fax_number": "561-776-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MILITARY TRAIL",
            "address_2": "# 219",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458",
            "telephone_number": "561-844-0715",
            "fax_number": "561-776-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES GENERAL & COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "KACHAM",
        "authorized_official_first_name": "SHARADA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-844-0715"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.