Smileville PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SMILEVILLE PLLC

Doing business as

Reform Dentistry

Practice address

10009 Southpoint Pkwy Ste 201
Fredericksburg, VA 22407-2710

Phone

(540) 237-1700

NPI assigned

May 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ali Al-Douri, DDSNPI 1780120717

Title

Director

Phone

(540) 237-1700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reform Dentistry Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ali Al-Douri, DDS

  • Dentist
  • Fredericksburg, VA
  • NPI 1780120717
  Authorized official Same address or phone
• Zainab Mohammed Baker

  • Dentist
  • Fredericksburg, VA
  • NPI 1417671678
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1417515180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8223 COTTAGE ST",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221806940",
            "telephone_number": "202-680-0866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10009 SOUTHPOINT PKWY STE 201",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224072710",
            "telephone_number": "540-237-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILEVILLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "AL-DOURI",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "540-237-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780120717",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reform Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Dale Slovak, LICENSED OPTICIAN
• Shawn Renea Small Sanders, ANPBC
• Smart Prime Care Provider PLLC (Smart Prime Care)
• Samuel C Smart, DOCTOR OF OPTOMETRY
• Smile Co FXBG Dentistry, PC
• Lavonna Smith-Tyler
• Aracoma S Smith, LCSW
• Ashley Dawn Smith, LMT
• Barbara Sprinkle Smith, B.S., C. M.T.
• Betsy Smith, PHARMD

• Dental Clinic/Center in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Dental Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.