DC Smiles Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DC SMILES DENTISTRY, PC

Practice address

3401 Georgia Ave NW
Washington, DC 20010-2501

Phone

(202) 829-5437

Fax

(202) 828-9255

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Jenell Stump

Title

Manager, Licensing & Credentialing

Phone

(615) 750-0343

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1386756617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 ARCADE UNIT 198747",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372191994",
            "telephone_number": "615-750-0343",
            "fax_number": "615-986-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102501",
            "telephone_number": "202-829-5437",
            "fax_number": "202-828-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DC SMILES DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "STUMP",
        "authorized_official_first_name": "JENELL",
        "authorized_official_title_or_position": "MANAGER, LICENSING & CREDENTIALING",
        "authorized_official_telephone_number": "615-750-0343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411037400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038292200",
            "state": "DC"
        }
    ],
    "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 9, 2014; 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.