NPIMap

Organization Active NPI

Peoria Healthy Smiles LLC

  • Dentist
  • Peoria, AZ
National Provider Identifier
1346661964
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
AZ8063 Issued in AZ
Legal business name
PEORIA HEALTHY SMILES LLC
Practice address
13660 N 94TH Dr Ste E3
Peoria, AZ 85381-4209
Phone
(623) 974-4799
NPI assigned
Dec 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Authorized official

Name
Dr. Gina Michelle Elrod, DDS
Title
Owner
Phone
(623) 974-4799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X AZ8063 AZ Primary

Addresses

Primary practice location

13660 N 94TH Dr Ste E3
Peoria, AZ 85381-4209

Mailing address

13660 N 94TH Dr Ste E3
Peoria, AZ 85381-4209
Phone (623) 974-4799

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1346661964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE E3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814209",
            "telephone_number": "623-974-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE E3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814209",
            "telephone_number": "623-974-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA HEALTHY SMILES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-27",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "ELROD",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-974-4799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "AZ8063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.