NPIMap

Organization Active NPI

David M Vieth DDS, a Professional Corporation

Doing business as Kool Smiles

  • General Practice Dentistry
  • Shreveport, LA
National Provider Identifier
1346571866
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DAVID M VIETH DDS, A PROFESSIONAL CORPORATION
Doing business as
Kool Smiles
Taylor Dental
Practice address
3735 Jewella Ave
Shreveport, LA 71109-4703
Phone
(800) 920-9947
NPI assigned
Jan 22, 2010
Last updated
Mar 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Authorized official

Name
David M V Ieth, DDS
Title
President
Phone
(770) 916-5036

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

3735 Jewella Ave
Shreveport, LA 71109-4703

Mailing address

1090 Northchase Pkwy SE Ste 150
Marietta, GA 30067-6407
Phone (770) 916-5028

Other names 2

  • KOOL SMILES Doing business as
  • Taylor Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David M Vieth DDS a Professional Corporation9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3735 Jewella Ave
Shreveport, LA 71109
Phone (318) 759-0131

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553212800000",
    "number": "1346571866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE STE 150",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676407",
            "telephone_number": "770-916-5028",
            "fax_number": "678-247-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 JEWELLA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711094703",
            "telephone_number": "800-920-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M VIETH DDS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-22",
        "last_updated": "2019-03-22",
        "status": "A",
        "authorized_official_last_name": "V IETH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-916-5036",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KOOL SMILES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Taylor Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

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