Smile Club-Dayton PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SMILE CLUB-DAYTON PLLC

Practice address

400 E Highway 90 Ste 402
Dayton, TX 77535-2630

Phone

(936) 681-8592

Fax

(936) 681-8599

NPI assigned

Jan 7, 2019

Organization subpart

No

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

Authorized official

Name

Tee Semera

Title

Credentialing

Phone

(469) 556-9000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1366915969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 W GREEN OAKS BLVD STE 101",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760138349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E HIGHWAY 90 STE 402",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775352630",
            "telephone_number": "936-681-8592",
            "fax_number": "936-681-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE CLUB-DAYTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "SEMERA",
        "authorized_official_first_name": "TEE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "469-556-9000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Grayson Stockwell, FNP-C
• Lori Beth Swearingen
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• General Practice Dentistry in Dayton, TX
• Providers in Dayton, TX by specialty
• General Practice Dentistry in Texas

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