Fresh Smiles PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

24365 Issued in TX

Legal business name

FRESH SMILES PLLC

Practice address

2001 W. St Hwy 71
Suite 20
La Grange, TX 78945

Phone

(817) 451-4740

NPI assigned

Feb 23, 2017

Organization subpart

No

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

Authorized official

Name

Gaurav Puri

Title

Owner Dentist

Phone

(817) 451-4740

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1417496415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W. ST HWY 71",
            "address_2": "SUITE 20",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "78945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W. ST HWY 71",
            "address_2": "SUITE 20",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "78945",
            "telephone_number": "817-451-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRESH SMILES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-23",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "PURI",
        "authorized_official_first_name": "GAURAV",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "817-451-4740"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "24365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fayette County
• Fayette Medical Supply, Inc.
• Marc A Fitzpatrick, D.C.
• Samantha Fleming
• Angelia Kay Foreman
• Fresh Smiles-la Grange PLLC
• Katherine Gross, LPC
• Robert K Guillory, DC
• H-E-B, LP
• Robert Henry Hamff, RPH

• Dentist in La Grange, TX
• Providers in La Grange, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.