NPIMap

Organization Active NPI

Jessica Lee Smiles, LCC

Doing business as Abundant Smiles

  • Dentist
  • Denver, CO
National Provider Identifier
1376099002
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00202605 Issued in CO
Legal business name
JESSICA LEE SMILES, LCC
Doing business as
Abundant Smiles
Practice address
1220 W 38TH Ave
Denver, CO 80211
Phone
(303) 317-6990
NPI assigned
Sep 1, 2016
Last updated
Sep 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Dr. Jessica Mervau, DDSNPI 1700298387
Title
Owner
Phone
(269) 908-1589

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 00202605 CO Primary

Addresses

Primary practice location

1220 W 38TH Ave
Denver, CO 80211

Mailing address

1220 W 38TH Ave
Denver, CO 80211
Phone (303) 317-6990

Other names 1

  • Abundant Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

1220 W 38th Ave
Denver, CO 80211
Phone (303) 317-6990

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1376099002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 W 38TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-317-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 W 38TH AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80211",
            "telephone_number": "303-317-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA LEE SMILES, LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "MERVAU",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-908-1589",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abundant Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.