Organization Active NPI

Smiles Kingdom Inc

  • Dentist
  • Port Orange, FL
National Provider Identifier
1407215965
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19830 Issued in FL
Legal business name
SMILES KINGDOM INC
Practice address
3751 Clyde Morris Blvd
Unit 7
Port Orange, FL 32129-2356
Phone
(386) 310-3060
Fax
(386) 872-5021
NPI assigned
Feb 12, 2016
Organization subpart
Yes
Parent organization
TABORDA DENTISTRYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Authorized official

Name
Dr. Steve D Taborda, DMDNPI 1528323581
Title
Dentist
Phone
(386) 299-5625

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN19830 FL Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DN21034 FL

Addresses

Primary practice location

3751 Clyde Morris Blvd
Unit 7
Port Orange, FL 32129-2356

Mailing address

3751 Clyde Morris Blvd
Unit 7
Port Orange, FL 32129-2356
Phone (386) 310-3060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1407215965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 CLYDE MORRIS BLVD",
            "address_2": "UNIT 7",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292356",
            "telephone_number": "386-310-3060",
            "fax_number": "386-872-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 CLYDE MORRIS BLVD",
            "address_2": "UNIT 7",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292356",
            "telephone_number": "386-310-3060",
            "fax_number": "386-872-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILES KINGDOM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TABORDA DENTISTRY",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "TABORDA",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "386-299-5625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19830",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.