Organization Active NPI

Smile Squad of Houston 249 PLLC

  • Dentist
  • Houston, TX
National Provider Identifier
1407407893
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SMILE SQUAD OF HOUSTON 249 PLLC
Practice address
11740 State Highway 249 Ste a
Houston, TX 77086-4133
Phone
(281) 713-5780
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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

Authorized official

Name
Amanda Navarro
Title
Credentialing Consultant
Phone
(832) 689-6311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11740 State Highway 249 Ste a
Houston, TX 77086-4133

Mailing address

11740 State Highway 249 Ste a
Houston, TX 77086-4133
Phone (281) 713-5780

Other names 1

  • Smile Squad Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL smilesquad@gmail.com

National Provider Directory

National Provider Directory

Locations

11740 State Highway 249
Ste A
Houston, TX 77086
Phone (281) 713-5780

Practitioners & affiliated clinicians

Practitioners 2

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": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1407407893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 STATE HIGHWAY 249 STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770864133",
            "telephone_number": "281-713-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 STATE HIGHWAY 249 STE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770864133",
            "telephone_number": "281-713-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE SQUAD OF HOUSTON 249 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CREDENTIALING  CONSULTANT",
        "authorized_official_telephone_number": "832-689-6311"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "smilesquad@gmail.com",
            "affiliation": "N",
            "address_1": "11740 State Highway 249 Ste A",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770864133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Smile Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.