Mobile Smiles P.a. LLC

Primary specialty

DentistTaxonomy code 122300000X

License

12009992 Issued in IN

Legal business name

MOBILE SMILES P.A. LLC

Doing business as

Smiles Express

Practice address

5868 E. 71St St
Indianapolis, IN 46220-4002

Phone

(317) 759-1020

NPI assigned

Aug 28, 2016

Organization subpart

No

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

Authorized official

Name

Heather Keith

Title

Office Manager

Phone

(317) 759-1020

Specialties & licenses 1

Addresses

Other names 1

• Smiles Express Doing business as

Locations

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1417403718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5868 E 71ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204075",
            "telephone_number": "317-759-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5868 E. 71ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204002",
            "telephone_number": "317-759-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE SMILES P.A. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-759-1020"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IN",
            "license": "12009992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kyle Mobley, LCSW

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.